Management tools are intensifying across markets, including more prior authorization, step therapy, formulary exclusions, and biosimilar preferencing, with spillover from Part D into commercial ...

Retinal anti-VEGF regimens requiring frequent monitoring generate indirect patient costs that often outweigh direct expenses ...

A retrospective study of 174,250 retina practice patients found that dismissals, though rare, disproportionately affected younger, lower-income patients with diabetic retinopathy, raising equity and ...

Survey responses (166/708 partners) showed 52% had ≥1 award canceled, 81% were asked to restrict activities, and 3% closed permanently. PEPFAR prevention spending was reported to drop 51% from 2024 to ...

For individuals living with chronic conditions, stable housing enables consistent care. Conversely, housing instability can disrupt care continuity, increase financial strain, and contribute to ...

Dismissals occurred in 432 of 174,250 patients (0.25%), with noncompliance (60.2%) and aggressive or inappropriate conduct (18.2%) comprising the majority of cited reasons. Demographic differences ...

Retrospective Cleveland Clinic data (89 eyes) linked branded-to-bevacizumab switching with increased CST, shortened median injection interval (8.6 to 7.5 weeks), and 15.7% meeting poor-outcome ...

State-by-state Medicaid payment differed markedly, with 34 states (82% of enrollees) paying less than Medicare and 18 states paying under 80% of Medicare. Extremes included Nebraska at 184% of ...

IRIS Registry analysis captured first faricimab injections from Feb 2022–Sep 2023, requiring ≥12 months pre-index data and ≥24 months follow-up to characterize longitudinal real-world utilization.

Aimée K. Dailey, president of Government Health Benefits at Elevance Health | Authors | Managed Healthcare Executive gives C-suite executives in health plans and provider organizations news and ...