CMS Expects Medicare Prescription Premiums to Rise

In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.

President Donald Trump has sent letters to pharmaceutical companies, aiming to compel them to lower drug prices in the US to match the lowest prices offered in other developed nations, a move that could significantly reduce costs and disrupt the current system of pharmacy benefit managers.

This Managed Care Cast episode explores how high costs and inconsistent insurance coverage for incretin mimetics impact obesity management and patient care.

Supplemental Nutrition Assistance Program (SNAP) benefits may slow cognitive decline in older adults, highlighting the importance of food assistance in combating Alzheimer disease and dementia risks.

Key legal, ethical, and compliance considerations for managed care professionals navigating the evolving landscape of psychedelic-assisted therapy include regulatory risks, data privacy challenges, reimbursement limitations, and the need for culturally informed care models.