News

Managed Healthcare Executive asked several experts in healthcare and managed care to share the trends they think the industry is overlooking. From rising costs and data challenges to shifts in how care is delivered, these are the issues that could have a major impact — and deserve a closer look.

Patients and providers found common ground on the importance of correct billing estimates but did not see eye to eye in terms of digital scheduling tool use, according to a new survey by Experian Health.

There is a lack of agreement on the clinical, psychological and social relevance of menopause between the transgender and gender diverse communities and medical professionals, according to the results of a study published this month in Menopause.

Researchers of a new JAMA study said that without further participation in accountable care organizations, including the ACO REACH model, the program is unlikely to meet its goal of reducing health disparities.

CVS Health released a statement shortly after HB1150 was signed in Arkansas, prohibiting pharmacy benefit managers from owning pharmacies.

In a recent conversation with Managed Healthcare Executive, Geoffrey Rutledge, M.D., of HealthTap, warned that the narrative around GLP-1 drugs is often oversimplified—and potentially harmful.

On lobbying, hospitals, PBM reform and 340B

On lobbying, the political power of hospitals, PBM reform and 340B

Women who undergo menopause before the age of 40 are more likely to experience cognitive decline, which may lead to dementia, according to new research.

Here’s what you missed this week on Managed Healthcare Executive.

Maureen Corcoran, director of the Ohio Department of Medicaid, believes the work requirement policy can be both a financial and moral effort to improve the lives of Medicaid consumers.

Medicaid is the main healthcare coverage for people living with HIV in the United States, according to data compiled by KFF.

With policymakers considering work requirements for Medicaid eligibility, Jennifer Haley, principal research associate in the Health Policy Division at the Urban Institute, said it’s more important than ever to understand how those changes could unintentionally cause harm, particularly when data systems fall short and public awareness is limited.

The difference between specialty drugs and traditional drugs and how each have vied for market competition, according to Jeff Casberg, MS, RPh, senior vice president of clinical pharmacy services at IPD Analytics.

The insurer’s healthcare expenses, especially physician and outpatient services, within the Medicare Advantage businesses were above what company leaders had expected.

In this first part of a two-part video series, Jennifer Haley, principal research associate of the Health Policy Division at the Urban Institute, spoke with MHE about the impact the proposed Medicaid work requirements could have on millions and research that supports this belief.

A Q&A between Shawn Kwatra, M.D., professor and chair of dermatology at the University of Maryland School of Medicine, and Managed Healthcare Executive about new discoveries in chronic itch, how treatment options are improving and the challenges patients face in getting access to the right therapies.

The analysis from the Urban Institute breaks down projected coverage losses across the 40 Medicaid expansion states, where researchers based their estimates on previous work requirement rollouts in Arkansas and New Hampshire.

In a Q&A with Jeff Casberg, MS, RPh, senior vice president of clinical pharmacy services at IPD Analytics, Casberg explains the evolution of specialty drugs, the future of GLP-1 competition and what to expect from the traditional drug pipeline.

Here’s what you missed this week on Managed Healthcare Executive.

Qfitlia (fitusiran) is the first therapy for both hemophilia A or B, with or without inhibitors, available in the United States.

The CEOs of CVS Health and UnitedHealth Group praised pharmacy benefit managers and promised transparency during investor calls. A critic of the “big 3” dismissed the statements as posturing.

Several drugs in development would block neonatal fragment crystallizable receptor (FcRn) as a way of reducing the autoantibodies that cause myasthenia gravis.

Current observations and foresight into the world of biosimilars, GLP-1s, PBM and payer trends, according to Jeff Casberg, MS, RPh, senior vice president of clinical pharmacy services at IPD Analytics, and Doug Long, MBA, vice president of industry relations at IQVIA.

In United States veterans, antiretroviral resistance was associated with higher healthcare resource utilization, despite lower pharmacy-related costs, according to an abstract submitted to the Academy of Managed Care Pharmacy (AMCP) held last week in Houston.

United Health Foundation, the charitable branch of UnitedHealth Group, awarded more than $7 million in grants to organizations in Georgia, Michigan, New Mexico and Wisconsin to improve maternal and infant healthcare, reduce disparities and strengthen the doula workforce in underserved communities.

The Xpert MTB/Ultra molecular diagnostic test may become a viable option for detecting tuberculosis (TB) in the stool of adults with HIV, according to the results of a recent study.

At the 2025 AMCP annual meeting in Houston from March 31 to April 3, John M. O'Brien, Pharm.D., MPH, president and CEO of the National Pharmaceutical Council (NPC), shared concerns and potential reforms in a conversation with Managed Healthcare Executive.

Here’s what you missed this week on Managed Healthcare Executive.

Originally developed to treat Type 2 diabetes, glucagon-like peptide 1 (GLP-1s) are now being studied to explore their effects on various other conditions, such as sleep apnea, substance use disorder and Alzheimer’s disease, according to panelists participating in a keynote session of the Academy of Managed Care Pharmacy annual meeting today in Houston.