For the healthcare industry, this crisis isn’t just about financial risk — it’s about consumer trust. When patients can’t afford care, they disengage, often convinced the system isn’t built for them. And when trust erodes, so do outcomes — because people who don’t trust the system are less likely to seek care at all. The…
Using Medicare Advantage encounter data, this analysis finds that 62% of Medicare Advantage enrollees have at least one chart review record and that diagnoses added from chart reviews increase payments from CMS to insurers for 17% of enrollees. The use of chart reviews varies across the largest Medicare Advantage insurers.
Johnson & Johnson announced last week a major change in the way it offers 340B pricing for two medications. The change is “inconsistent” with the 340B statute, according to HRSA. The post J&J’s Change to 340B Discounts is “Inconsistent” with Statute, HRSA Says appeared first on MedCity News.
[Sponsored] At INVEST Digital Health 2025, David Snow, Executive Director of Pegasus Park, discussed building a life science innovation hub and why life science startups at the North Texas campus are more likely to survive, scale, and exit. The post The Burgeoning Life Science Ecosystem of North Texas, Anchored by Pegasus Park appeared first on…
The convergence of Trump’s political capital, Kennedy’s agricultural vision, and existing technological capabilities creates an unprecedented opportunity to restructure America’s approach to health and disease prevention. The post Trump, RFK Jr., and the Healthcare Bombshell No One Sees Coming appeared first on MedCity News.
[Sponsored] A new report from Imagine360 makes the case that when it comes to healthcare from self-insured employers, the focus should be more on affordability and less on escalating healthcare costs. The post Restoring Affordability to Employer Health Plans appeared first on MedCity News.
September has seen a wide range of executive hires, exits, promotions and layoffs across the healthcare industry. For example, Medtronic, Amgen and Kaiser Permanente welcomed new executives. There were also layoffs at organizations including Novo Nordisk and Seattle Children’s. The post Healthcare Moves: A Monthly Summary of Hires, Exits and Layoffs appeared first on MedCity…
Jonnell Wieder earned too much money at her job to keep her Medicaid coverage when the covid-19 public health emergency ended in 2023 and states resumed checking whether people were eligible for the program. But she was reassured by the knowledge that Medicaid would provide postpartum coverage for her and her daughter, Oakleigh McDonald, who…
We have an imperative to restore trust in science and continue to advance equity, and we have the means to do so with technology, data connections, and dedicated healthcare professionals. It is also critically important to preserve our expert scientific and public health resources so they can ensure we are prepared for the next crisis. The…
By MATTHEW HOLT There’s been a lot of discussion lately about whether digital health is a legitimate place for venture capital. There have been lots of huge failures, very few notable successes (and certainly no “biggest companies in the world” yet, while some real giants (Walmart/Walgreens/Amazon) have come in and then got out of health…