GAO Push for Lower Dialysis Bundle Spurs Controversy

Laxmi Patel discusses proposed Medicaid reforms in HR 1, including work rules, coverage limits, and state-level risks for vulnerable populations.

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

Pulse of the Purchaser 2025 survey results showed the use of transparent PBMs more than doubled in just 1 year, from 12% to 31%.

Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.

Many states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences.

To mark the 30th anniversary of The American Journal of Managed Care, each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The September issue features a conversation with Dora Hughes, MD, MPH, chief medical officer and director of the Center for Clinical Standards and Quality at CMS.