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CMS Drug Price Negotiations: A Path to Affordable Medication Access
The landscape of Medicare is undergoing a transformative change, driven by the Inflation Reduction Act of 2022 and the Centers...
Hospitals and Health Systems
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The Hidden Costs of Provider Abrasion for Payers
Strategies to Enhance Collaboration A time-consuming authorization process. Complex claim submission and reimbursement processes. Lack of transparency and communication. These...
Practices and Medical Groups
hundred dollar bill with prescription pills coming out of it
Cracking Down on Drug Prices: A Prescription for Positive Change
In the ever-evolving landscape of American healthcare, one issue remains a constant concern for patients, providers, payers, and policymakers alike—the...
Thought Leadership
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Pharmacy Benefit Managers in the Crosshairs
Pharmacy benefit managers (PBMs) have become the hot potato of the healthcare industry that nobody wants to hold. State and...
Healthcare Payer Organization
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The Rising Costs of Chronic Diseases: How Payers Can Respond
The financial impact of chronic disease in the U.S. is sobering. According to the Centers for Disease Control (CDC), 90%...
Thought Leadership
Stock photo of a cancer cell
CAR T-cell Therapy: Genetically Modifying the Immune System to Attack Blood Cancer and Clinical Applications in Nursing Practice
They’re often called the four “pillars” of cancer treatment because of their prevalence. Physicians have used surgery, chemotherapy, radiation therapy,...
Thought Leadership
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Payers Take a Hit from Lower Medicare Advantage Star Ratings
Now that the Centers for Medicare & Medicaid Services (CMS) has lowered the boom on payers by dropping the star...
Healthcare Payer Organization
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Five Recession-proof Strategies for Payers
Economists can’t agree if the U.S. is headed for a “soft landing” recession, a hard landing, or no recession at...
Thought Leadership
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Oncology Spending to Reach $125 Billion in Five Years
While spending on oncology drugs in the U.S. is anticipated to reach $125 billion by 2027, overall drug savings of...
Hospitals and Health Systems
Manisha Sharma headshot with blue background
Health Equity, Women’s Health, and Artificial Intelligence Take Center Stage at AHIP 2023
After attending my first AHIP (America’s Health Insurance Plans) national conference, I was struck by the level of engagement and...
Thought Leadership
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From Buy-and-Bill to White Bagging: The Evolution of Oncology Drug Procurement
With the median cost of new oncology drugs over $260,000, it’s no wonder payers continue to look for opportunities to...
Legislation

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