Commercial health insurers can participate in the rapidly growing Medicare Advantage (MA) market, which may affect network formation and prices in traditional commercial insurance markets.

The recent reversal of prescription delivery flexibilities, which were permitted during the COVID-19 Public Health Emergency (PHE), has raised concerns in the medical community.

One large health system with hospitals in Virginia and Ohio this year cut off in-network access to consumers enrolled in some Anthem Blue Cross Blue Shield Medicare and Medicaid health insurance plans.

More workplaces are offering at least one health plan that is free to employees or offers no-deductible coverage for certain services as many workers struggle to afford care.

Over half of the US population receives health insurance from private insurers, and prices are negotiated rather than set administratively (eg, Medicare). This negotiation process contributes to a landscape in which private insurance prices are both higher than Medicare rates and highly variable.1

Some pharmacy staff from Walgreens and other drugstore chains are planning to walk out this week in the latest pushback against what they call unsafe working conditions that put both employees and patients at risk.

As part of our coverage of the 2023 COA Payer Exchange Summit, The American Journal of Managed Care® spoke with Ted Okon, MBA, executive director, Community Oncology Alliance, to learn more about early returns from the Enhancing Oncology Model (EOM) and how community practices are innovating in ways that can expand beyond the community oncology landscape into other areas of medicine.

After more than a decade of educating members of Congress on terms such as pharmacy benefit managers (PBMs) and site neutrality, leaders of the Community Oncology Alliance (COA) have bipartisan support in the Congress for key agenda items, with hope that some will pass by year’s end.