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JAMA Internal Medicine editor and a UCSF colleague wrote in a New England Journ of Medicine opinion piece that the decision highlights the need to establish a new requirement that would make coverage decisions contingent on evidence of benefit for Medicare population.

Seventy-one percent of healthcare executives agree that shifting home-based cancer care to their healthcare organizations as soon as possible will create "organizational success," according to a Reimagine Care survey.

In this week’s episode Briana Contreras, associate editor of Managed Healthcare Executive, met with Greg Miller, vice president of Industry Strategy, Healthcare and Life Sciences at Talkdesk. The two discussed that while virtual care has become a convenient tool in healthcare during the pandemic and has helped treat more patients, this form of care isn’t completely solving patient’s underlying issues. However, Miller shared how AI is helping ease the patient experience and improving care in this conversation.

ICER’s review indicates that Humira’s price increases are not supported by new clinical evidence.

Despite advances in medical science and technology, our healthcare system doesn’t always translate knowledge into practice. All too often, this leaves healthcare providers questioning the key business decisions that impact patient care. What caregivers need is a model for applying new technology safely and appropriately. Thankfully, such a model exists: the High Reliability Organization (HRO) model.

A new study suggests clinicians might be able to use metabolic “fingerprints” to better understand the likely severity of individual cases.

Collaboration among stakeholders is needed to increase transparency of pharmacy payment programs and to better align the design of these models with good patient care.

Branded and unbranded versions of the interchangeable biosimilar to treat patients with diabetes are now available.

Investigators in Japan have developed a new, noninvasive method for screening for spinal muscular atrophy using saliva analyzed with conventional PCR as an alternative to blood-based genetic screening.

The integration of virtual and in-person care, and expansion of mental health services is among the top health and well-being trends for next year.

Long term care industry facing worst job loss among all healthcare providers.

President Biden nominates new FDA commissioner, and the agency has approved a liquid form of a seizure medication and a new treatment for a rare blood disease. The FDA also accepted a supplemental NDA for Jardiance this week.

For health insurance executives, pursuing the Quadruple Aim is the name of the game.

Califf, who is described by some as a safe choice for the agency’s top job, headed the FDA during the last year of the Obama administration.

Site of service has a major effect on the cost. Home infusion and oral formulations are challenging both hospital- and physician-based infusions.

Patients with chronic lymphocytic leukemia, non-Hodgkin lymphoma, Hodgkin lymphoma, and multiple myeloma were more likely to have a COVID-19 breakthrough infection.

Smaller PBMs are rated higher by health plans in terms of satisfaction because of their ability to offer more customized solutions.

In an interview with Managed Healthcare Executive®, Ty Gluckman, M.D., FACC, FAHA, provides helpful explanations of hypertrophic cardiomyopathy diagnosis and treatment

Treating high levels of low-density lipoprotein cholesterol in young people may reduce lifetime exposure and lead to fewer cases of coronary heart disease.

A new report suggests infants who do not get enough sleep can quickly become overweight.

In an interview with Managed Healthcare Executive®, Ty Gluckman, M.D., FACC, FAHA, explains the definition, incidence and pathophysiology of hypertrophic cardiomyopathy.

Briana Contreras, associate editor of Managed Healthcare Executive, spoke with Josh Benner, founder and CEO of RxAnte, in this latest episode of Tuning In to the C-Suite podcast. In the conversation, Benner addressed the issue of medication misuse among patients based on access, demographics and more, as well as its solutions. The two also talked about the role technology has on the future of pharmacy and how solutions provided through RxAnte can assist plans to improve their CMS Start rating measures.

Diabetes and obesity rates are high among Latinos. To lower them, providers and payers need to understand cultural factors and barriers to healthcare.

Interviews with 32 patients shows a wide range of experiences but authors say one takeaway is a need for better coordination between HCM specialist and community cardiologists.

The Pfizer and Moderna COVID-19 vaccines introduced much of the world to ribonucleic acid (RNA), which has long played second fiddle to DNA. But in addition to the messenger RNA vaccines, treatments targeting and using RNA in a variety of ways are filling the pipeline and exciting researchers and drug developers.

Per episode saving of $297 during the first three years of the value-based care model were offset by $704 in payments for enhanced services to the 201 participating practices, study finds.

COVID-19 is not in the rearview mirror. Greater collaboration among organizations, and a new sense of purpose with regard to interoperability, is essential in this new era.

Paxlovid, an at-home treatment for COVID-19, reduces illness severity, hospitalizations, and deaths among adults by 89%.

The agency has been in the spotlight because of the pandemic, questions about its independence and the approval of Aduhelm. The stakes are high and the politics, fraught.