The private plans that offer the Medicare Part D benefit – stand-alone drug plans and Medicare Advantage drug plans – are increasingly are competing on uneven terms, in part because the payment system for Medicare Advantage plans enables them to lower Part D premiums or reduce Part D cost sharing, making drug coverage from Medicare…
The next phase of AI in healthcare is about building systems where human clinicians, supervisors, and AI can all contribute, challenge each other, and improve how decisions are made. The post From Copilots to Clinical Judgment: The Next Phase of AI in Digital Behavioral Health appeared first on MedCity News.
AI is not driving healthcare cost inflation. It is exposing a system that has always been designed to reward it, and making that system more efficient. As long as reimbursement is tied to intensity, every technological advancement will move in the same direction: toward maximizing it. The post AI Is Scaling Healthcare Costs Because the…
EHR switching involves risk. But taking a life cycle view, considering data migration, workflow configuration, training, downtime, ongoing fees and eventual exit terms, can put an end to your EHR pain. The post What Healthcare Leaders Get Wrong About EHR Switching appeared first on MedCity News.
This interactive tracks announced insurer exits from and entries into the ACA Marketplaces for 2027.
This brief features maps showing how insurer participation has changed at the state and county level from 2025 to 2026 as well as insight into the number of issuers offering plans at specific metal levels.
Two recent federal actions, including a memo about alleged COVID-19 vaccine deaths and settlements creating a “detransition clinic,” show how official actions can present uncertain or uncommon outcomes as representative and lend credibility to narratives that go beyond what evidence supports.
[Sponsored] A webinar sponsored by Verato and scheduled for June 17 from 1 pm to 2 pm ET will explore how a unified identity strategy, spanning patients, providers, and emerging solutions enabling accurate attribution, strengthens interoperability, and ultimately drives VBC success. Register today! The post The Identity Gap Undermining Value-Based Care appeared first on MedCity News.
President Donald Trump, who once declared he had “saved” flavored vapes, grew his stock holdings this year to as much as $1.64 million in tobacco giant Philip Morris. He also had holdings in Altria and a third leading tobacco company, though an apparent discrepancy in his disclosures clouds the extent of his investments. In 2025,…
When health economics emerged as a distinct discipline in the late 1960s, mainstream academic and policy paradigms widely presumed that competitive market mechanisms were structurally incompatible with medical delivery. Influenced by foundational ideas like Kenneth Arrow’s 1963 landmark paper emphasizing the pervasive friction of clinical uncertainty, early experts argued that society had to look almost…