By MATTHEW HOLT It’s hard to imagine but I may now be in possession of the stupidest letter I’ve ever received from an American health insurance company–-and I’m the guy who got five identical letters on one day from Blue Shield of California telling me that they had changed my primary care doctor when I…
KFF reports on the increased use of copay accumulators: Oscar Health is one of many commercial health insurers that use what are often called copay accumulator programs to keep funds that are meant to defray patients’ out-of-pocket costs for expensive specialty drugs. Over the past decade, more insurers have adopted such strategies to reduce their prescription…
Ascension is set to acquire Williamson Health, a county-owned health system in Tennessee, in a deal worth nearly $1 billion. Ascension’s offer beat out bids from HCA Healthcare and Optum. The post Ascension to Buy Tennessee Health System for Nearly $1B appeared first on MedCity News.
Elevance filed a lawsuit last week against the Department of Health and Human Services and the Centers for Medicare & Medicaid Services, alleging that CMS unlawfully refused to recalculate Elevance’s 2026 Medicare Advantage Star Ratings on the same basis that it recently recalculated Clover Health’s ratings after a court ruling. The post Elevance Sues CMS…
Vertex Pharmaceuticals’ acquisition of Crinetics Pharmaceuticals values the company at about $10 billion. Crinetics’s Palsonify could become a new standard of care therapy for acromegaly and the biotech also brings other drugs in various stages of development for endocrine disorders, a new therapeutic area for Vertex. The post Vertex Pharma’s Growth Strategy Leads to Its…
As an increasing share of older adults have adopted digital health technologies over the past several years, and with most expressing interest in using them to manage their health care, the Centers for Medicare & Medicaid Services (CMS) has introduced several initiatives to expand the use of digital health technologies in Medicare. This brief summarizes…
AI performs best where a problem is well-defined, data-intensive, repetitive and operates at a scale that exceeds human tracking capacity. The supply chain hits all four. The post The AI Use Case That Healthcare is Overlooking appeared first on MedCity News.
Patients, providers, and innovators all benefit from secure, trusted, nationwide data exchange. But this trust cannot sustain itself on fragmented governance or competitive enforcement dynamics. The post The Foundation Is Built — Now We Must Secure the Future of Interoperability appeared first on MedCity News.
Testosterone is not just a “male hormone.” Women need it too. And pretending otherwise has left countless women struggling through midlife while being told everything looks “normal.” The post The Truth About Testosterone in Women: What Medicine Has Overlooked appeared first on MedCity News.
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…