Payment Reform Models

Osteoarthritis leads the burden, projected to affect 50% of postmenopausal women by 2045.

Delays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care, explains Colin Banas, MD, MHA, chief medical officer with DrFirst.

Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.

A quick roundup episode of major news and health policy developments from The American Journal of Managed Care.

Median overall survival was 5 months longer in patients with small cell lung cancer (SCLC) who received tarlatamab instead of chemotherapy after progression following platinum-based chemotherapy.

Democratic leaders assert the Emergency Medical Treatment and Labor Act (EMTALA) remains vital for emergency care, countering confusion from recent policy changes affecting abortion rights and patient safety.