Skin Substitutes Provide Example of ACOs’ Role in Identifying Fraud, Waste, and Abuse
HarmonyCares’ Will Robinson outlines how high-needs ACOs helped CMS identify and address huge spikes in wound care spending
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KFF Health News’ ‘What the Health?’: Live From AHCJ: Shock and Awe in Federal Health Policy
The Host Julie Rovner KFF Health News @jrovner @julierovner.bsky.social Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A…
How ACA Marketplace Costs Compare to Employer-Sponsored Health Insurance
This analysis compares ACA Marketplace costs to employer-sponsored health insurance costs and finds that individual market premiums have become more similar to employer-sponsored premiums since 2017. In 2024, individual market insurance premiums averaged $540 per member per month, slightly below the average $587 per member per month premium for fully-insured employer coverage.
Closing the Rural Divide with Device-enabled Virtual Care
Bringing care to people where they are improves community health outcomes — we must operate with more urgency to shore up care resources in rural areas. The post Closing the Rural Divide with Device-enabled Virtual Care appeared first on MedCity News.
Trump’s Executive Order on Prescription Drug Costs Delivers a Win for Pharma Companies
The Trump administration aims to change the Medicare Drug Price Negotiation Program in a way that would delay when certain drugs can be selected for negotiation. The post Trump’s Executive Order on Prescription Drug Costs Delivers a Win for Pharma Companies appeared first on MedCity News.
Digital Health Funding in H1 2025: Market Stabilizes, AI Dominates and Exits Return
Digital health funding held steady in the first half of 2025, with AI-focused startups capturing the majority of capital and driving rapid adoption among providers. The digital health space also saw two long-awaited IPOs as well as rising M&A activity, which are two signals of market maturity — but looming policy shifts may challenge long-term…
Takeda Is Waking Up the Narcolepsy Market With First-in-Class Drug, But Alkermes Is on Its Heels
Takeda Pharmaceutical’s oveporexton is designed to treat the root cause of narcolepsy. Statistically significant Phase 3 results for the twice daily pill were presented Monday during the World Sleep 2025 Congress in Singapore. The post Takeda Is Waking Up the Narcolepsy Market With First-in-Class Drug, But Alkermes Is on Its Heels appeared first on MedCity…
Medicaid’s Health Equity Problem Starts and Ends with Health-Related Social Needs (HRSNs). Why Are They Being Overlooked?
While federal healthcare programs focus their attention on ensuring healthcare resources exist for communities in need, HRSNs become critical drivers of whether individuals can actually access and benefit from these resources. The post Medicaid’s Health Equity Problem Starts and Ends with Health-Related Social Needs (HRSNs). Why Are They Being Overlooked? appeared first on MedCity News.
Capping Per Enrollee Spending Could Reduce Federal Medicaid Expenditures by $532 billion to Nearly $1 Trillion Over 10 Years Depending on How States Respond and Result in as Many as 15 Million People Losing Medicaid Coverage by 2034
As Congress considers ways to cut Medicaid spending to help finance the extension of federal tax cuts, a new KFF analysis finds that imposing a cap on federal spending per Medicaid enrollee—known as a “per capita cap”—could trigger a decrease in federal Medicaid spending over a 10-year period of $532 billion to almost $1 trillion,…More