Medicaid Enrollment & Spending Growth: FY 2025 & 2026
This brief analyzes Medicaid enrollment and spending trends for FY 2025 and FY 2026, based on data provided by state Medicaid directors as part of the 25th annual survey of Medicaid directors.
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Novo Nordisk Swoops In With $6.5B Bid to Top Pfizer’s M&A Deal With Obesity Biotech Metsera
Acquisition talks for Metsera that played out this year culminated in an agreement with Pfizer, which agreed to buy the obesity drug developer for $4.9 billion. Novo Nordisk, a finalist in that pursuit, is positioning itself as a deal spoiler with a new unsolicited offer that shells out much more upfront cash. The post Novo…
NextGen Healthcare, Kno2 Form Partnership to Improve Patient Care and Advance Interoperability
NextGen and Kno2 are leveraging Kno2’s QHIN to streamline data exchange
Are Health Insurance Companies the Reason for Our Health System’s Ills?
In this JAMA Health Forum column, KFF’s Larry Levitt examines the criticism that health insurance companies are facing from political leaders, and explores the industry’s role in both causing and addressing some of the health systems’ biggest problems, including rising costs and prior authorization review.
Copay Assistance Is Meant To Defray Patient Drug Costs. Some Insurers Keep It Instead.
For 16 years, Larry Gruber, a fitness coach from Wilton Manors, Florida, received a coupon card to help him pay for a psoriatic arthritis medication he needs that costs more than $7,700 a month. Each year, Amgen, which makes the drug, called Enbrel, sent the coupon card worth thousands of dollars, and that counted toward…
Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience
On May 14, the House Energy and Commerce Committee advanced its portion of a budget reconciliation bill to meet spending targets included in the budget resolution passed by Congress. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending…
MedCity Pivot Podcast: Self-insured Employers Weigh Benefits of GLP-1 Drugs
Personify Health Chief Medical Officer Jeff Jacques offers a window into companies’ strategies for including GLP-1 drugs in their health benefits. The post MedCity Pivot Podcast: Self-insured Employers Weigh Benefits of GLP-1 Drugs appeared first on MedCity News.
How Health Systems Can Thrive in Navigating the Specialty Pharmacy Landscape
Specialty pharmacies must meet complex requirements, introducing administrative requirements that can be challenging for health systems to manage internally. Here some strategies that can be employed. The post How Health Systems Can Thrive in Navigating the Specialty Pharmacy Landscape appeared first on MedCity News.
States’ Efforts To Alter Arcane Hospital Rules Mix Politics With Drama
Georgia is one of dozens of states that require health-care facilities to ask for permission to build or expand by obtaining “certificates of need.” Basically, state regulators get to decide whether a town needs a new hospital or long-term care center. If the need is deemed real, they’re granted a “CON.” The intent of the…
Hospitals & Clinics Still Paid Unequally for Same Care, Research Shows
A new Trilliant Health report revealed wide disparities in provider payments, with academic medical centers and certain payer-affiliated clinics receiving far higher reimbursements than their peers for the same services. The findings emphasize just how much opaque pricing practices continue to drive inequities in the U.S. healthcare system. The post Hospitals & Clinics Still Paid…