Peter Wehrwein, Managing Editor

Chris Klomp, the director of Medicare and the deputy administrator at CMS, spoke about the proposed rule designed to curtail at-home risk assessments and other tactics that large insurers have used to game Medicare Advantage risk adjustment.

The trade associations salvos came the day before the CEOs of five major insurers are expected to face tough questioning at two congressional hearings.

Colton Jones, M.D., of The University of Texas San Antonio, discusses aspirin for colorectal cancer prevention after presenting research comparing GLP-1s with aspirin at the 2026 ASCO Gastrointestinal Cancers Symposium earlier this month in San Francisco.

Australian researchers say the first shot may temporarily damp down the immune system, giving the latent varicella zoster virus a chance to activate and cause mild cases of shingles.

In a wide-ranging interview, Mitchell discussed the Purchaser Business Group Health’s health data demonstration project, employer fiduciary responsibility, consequences of the end of enhanced Affordable Care Act subsidies and direct contracting.

People taking glucagon-like peptide 1 (GLP-1) drugs were 36% less likely to develop colorectal cancer than those taking aspirin, according to a real-world, head-to-head study.

The approval comes two months after Jascayd (nerandomilast) was approved for idiopathic pulmonary fibrosis.

Dupixent, Opzelura, and Zoryve were among the medications that had additional FDA-approved indications in 2025.

Trial results presented at the annual meeting of the American Society of Hematology showed decided advantages of Hympavzi (mastacimab) over on-demand treatment with bypassing agents.

Clinicians are moving toward managing mild (Grade 1) cytokine release syndrome on an outpatient basis.

As the number of patients with multiple myeloma and lymphoma treated with CAR-T therapy increases, health systems are shifting post-infusion care from inpatient to outpatient settings. Research presented at the annual meeting of the American Society of Hematology shows the change slices costs by $19,180.

The chief medical officer of Genetix Biotherapeutics, formerly known as Bluebird bio, discusses timelines and operational challenges of the gene therapies Zynteglo for beta thalassemia and Lyfgenia for sickle cell disease.

The patient died from vent-occlusive liver disease, a well-characterized side effect of the busulfan, the myeloablative chemotherapy used to prepare the bone marrow for engraftment with the Casgevy-modified blood stem cells.

Scots ages 70-79 were 74% less likely to be hospitalized for shingles-related reasons if they were vaccinated against the disease, researchers report

Mark Nestor reveals groundbreaking insights on botulinum toxin's evolving science, enhancing its efficacy and expanding its medical applications in dermatology.

Discover how botulinum toxin injections in the glabella affect brain function, enhancing mood by altering emotional feedback from frowning.

Milliman’s Jennifer Cruz says plans are losing rebates because of steep price discounts negotiated under the Inflation Reduction Act. but that they need to be sure that renegotiation of rebate guarantees doesn’t get too broad.

Pharmacy benefit managers are approaching health plans with value-based contracts that consider lower costs on the medical benefit of the insurance, says Jennifer Cruz of Milliman.

Drugmakers are scrambling to set up direct-to-consumer programs in response to President Donald Trump’s executive orders. Should pharmacy benefit managers be worried? Are the programs good for patients?

Meet the newest member of the Managed Healthcare Executive editorial advisory board.

Milliman's Jennifer Cruz, Pharm.D., said health plans should be able to track rebates to their book of business and have strong audit rights.

Critics say it doesn’t address the misalignment and a shift from the major PBMs collecting fees instead of rebates.