Cuts to Medicaid have divided Republicans in the Senate

Here’s what you missed this week on Managed Healthcare Executive.

Employers are key to transforming healthcare by creating competitive, cost-effective networks independent of federal policy changes, according to Christoph Dankert, chief network officer of Carrum Health.

As sweeping policy shifts and rising restrictions threaten LGBTQ+ health access, providers, payers and employers reflect on what’s at stake in Pride Month's end—and what it will take to protect affirming equitable care for the future.

A separate Prime analysis, however, of year-over-year claims data for Wegovy and Zepbound only found an improvement in adherence in 2024, suggesting there is an evolving understanding of obesity treatment.

Of the 102,166 GLP-1s analyzed, 94% had some form of commercial insurance, yet cost-saving options were still widely overlooked.

Uninsured or self-pay obesity patients can get any dose of Wegovy for $299 from July 1–31, 2025. Patients can get their prescription filled through CenterWell Pharmacy, now associated with Novo Nordisk and WeightWatchers.

A new study finds that enrollees who had difficulty accessing care in Medicare Advantage plans were more likely to switch to traditional Medicare than to another MA plan.

Independent prescribing by health system pharmacists has decreased, but a survey shows greater involvement in emergency departments and an expanding role for pharmacy technicians.

Access to contraception is essential for reproductive health, yet women with disabilities face disproportionate obstacles.

This latest data is a change from previous survey answers, in which 71% of healthcare leaders expected improved profitability and 69% of leaders anticipated a rise in revenue in 2025, according to combined data from the Deloitte Center for Health Solutions.

Smart Communications surveyed 3,000 consumers worldwide to understand evolving expectations for digital customer experiences, especially in industries such as healthcare, insurance and financial services.

The letter, signed by 79 medical societies, expresses concern over recent federal immunization review policies and asks that vaccines remain available to patients without cost-sharing.

Since its approval in 2002, Humira has become the world’s top-selling drug—largely due to long-standing market exclusivity and rising prices in the U.S.

Hospital-at-home care delivers medical staff, equipment and treatments—such as IV infusions—directly to patients’ homes.

More than 50 insurers have pledged to streamline and simplify the prior authorization process through six new commitments.

Results presented at the 85th Scientific Sessions of the American Diabetes Association in Chicago highlight the potential for AI to detect disease before signs and symptoms occur.

Women primary care providers (PCPs) treating Medicare patients in a value-based care model achieved better patient outcomes and earned more per patient than male counterparts, despite receiving equal patient satisfaction ratings, highlighting a potential for value-based payment to help close the gender pay gap.

There has been no or some progress in most areas since a National Institute of Health consensus development project in 2020, according to a group of experts. But exception is important: Prevention of moderate or severe chronic graft-vs.-host disease.

While drug prices and insurance companies often draw scrutiny, the report shifts the spotlight to hospitals—particularly nonprofit systems—as the main contributor to inflating costs.

The 21st Century Cures Act expanded enrollment eligibility for Medicare Advantage to include people with end-stage kidney disease. Sometimes aggressive marketing followed.

Most gene therapies being studied for eye diseases are in earlier phases of development, and a third of the gene therapies being investigated are for age-related macular degeneration.

Ways health systems can support care teams treating postpartum hemorrhage and the potential impacts of the Trump administration’s diversity, equity and inclusion (DEI) policies, according to Abigail Wooldridge, assistant professor of Industrial and Enterprise Systems Engineering at the University of Illinois.

The FDA had resolved the shortage of Wegovy in April, and telehealth providers were advised to stop selling compounded semaglutide products. Novo Nordisk said that Hims & Hers continues to offer these compounded drugs.