Peter Wehrwein, Managing Editor

On lobbying, the political power of hospitals, PBM reform and 340B

Republicans are aiming for major reductions in federal spending, and Medicaid seems a likely target. But the politics of Medicaid are tricky as the program has expanded and covered more people.

In this second part of a video series, Shawn Kwatra, M.D., professor and chair of dermatology at the University of Maryland School of Medicine, described a common scenario where patients with severe atopic dermatitis must first try and fail multiple topical treatments, all while having widespread symptoms, before insurers will approve systemic therapies.

CMS announced today that Medicare Advantages would increase by 5.06% in 2026.

In a recent Managed Healthcare Executive K-Cast video series, R. Robert Auger, M.D., a psychiatrist and sleep specialist at the Mayo Clinic in Rochester, Minnesota, spoke about the diagnosis and treatment of narcolepsy and idiopathic hypersomnia. This is a written recap of that series.

By 2023, approximately 1 in 5 patients with non-small cell lung cancer or metastatic colorectal cancer were treated with a bevacizumab biosimilar.

Results from the SUMMIT trial suggest that tirzepatide is as effective in preventing heart failure events in those with chronic kidney disease as those without it, and there are signals that it has benefits for renal function.

Compared with other studies, the differences in outcomes between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) narrowed in the FAME 3 five-year follow-up study, but there were fewer myocardial infarctions and repeat revascularizations in the PCI group.

In this second part of his interview with Managed Healthcare Executive, John B. Buse, M.D., Ph.D., a professor at the University of North Carolina (UNC) School of Medicine and director of the UNC's Diabetes Care Center, discusses lifestyle management and GLP-1s.

John B. Buse, M.D., Ph.D., a professor at the University of North Carolina (UNC) School of Medicine and director of the UNC's Diabetes Care Center, pointed to research that has shown a price of $150 per month would make the GLP-1s cost-effective as a prevention measure.

The largest randomized study of fluid intake restrictions showed no benefit from the restrictions, according to its senior author.

Results show noninferiority to a full dose in preventing a recurrence of blood clots and an advantage when it comes to bleeding risks.

The HHS secretary’s plans would create a new Administration for a Healthy America (AHA) subagency and slash the department’s workforce by 25%, including 3,500 full-time positions at the FDA.

A growing mistrust of medical providers could be traced back to doubts about scientific validity and treatment costs, according to Luke Hansen, M.D., M.H.S., chief medical officer of Arcadia, a healthcare data analytics company.

Employers and Medicare trustees could come together and change the healthcare industry, leading to healthcare reform, according to Luke Hansen, M.D., M.H.S., and chief medical officer of Arcadia, a healthcare data analytics company.

Luke Hansen, M.D., M.H.S., chief medical officer of Arcadia, a healthcare data analytics company, explains that the Make America Healthy Again initiative’s focus on chronic disease support will benefit value-based care and preventative care.

Moving away from accountable care organizations (ACOs) will not lead to value-based care, according to Luke Hansen, M.D., M.H.S., and chief medical officer of Arcadia, a healthcare data analytics company.

Luke Hansen, M.D., M.H.S., and chief medical officer of Arcadia, a healthcare data analytics company, said that achieving value-based care will need to be a multipronged approach with commercial purchasers and state Medicaid programs playing a prominent role.

An overview of Arcadia, a healthcare data analytics company, according to chief medical officer, Luke Hansen, M.D., M.H.S.

At a Senate confirmation hearing for CMS administrator, Mehmet Oz, M.D., would not answer directly whether he would support budget cuts to the Medicaid program.

Gilead has reported results for a once-yearly intramuscular injection that show blood concentrations of lenacapavir exceeded those from the twice-yearly dosing.

A Columbia University dermatologist argues that physicians in her specialty should be on the lookout for metabolic syndrome and obesity — and treat it.

Reaching out to waitlisted patients and organizing the staff into high-volume teams for a week shrank the waitlist from more than 3,000 unseen patients to 300.

A reduction in emergency room visits is just one of the ways teledermatology has improved patient outcomes and reduced costs, according to Elizabeth K. Jones, M.D., an associate dermatology professor at Thomas Jefferson University Hospital in Philadelphia.

An overview of the definition of teledermatology and it’s three subtypes, according to Elizabeth K. Jones, M.D., FAAD, an associate dermatology professor at Thomas Jefferson University Hospital.