When A Plan Overpays For A Service, Is A Patient Responsible For A Refund?

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 October issue features a conversation with Ge Bai, PhD, CPA, professor of accounting at Johns Hopkins Carey Business School and professor of health policy and management at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

The Trump administration advances the Most Favored Nation order by partnering with Pfizer, which came to the table voluntarily and has been granted a reprieve from upcoming drug tariffs.

Sadie Dobrozsi, MD, of Evolent, discusses how predictive genomics is pushing cancer care into a new era of personalization

Laxmi Patel explains how providers can meet potential new Medicaid documentation requirements without harming patient access.

A RAND report shows Medicare’s 3-year insulin savings model cut costs, improved access for beneficiaries, and offers lessons for future drug pricing reforms.