Authors



Lauren Biscaldi

Latest:

Takeaways from Senate Hearing on Semaglutide Pricing

Novo Nordisk said it’s open to discussions with PBMs based on their commitments that a lower semgalutide list price would not impact formulary coverage.


Brian Drozdowicz

Latest:

Unlocking the Hidden Potential of Modern Care Management

Health plans must embrace real-time member awareness, timely clinical context and actionable insights to realize the benefits of care management.


Denise Myshko

Latest:

MIT Develops Device to Address Type 1 Diabetes Complication

In a study in mice, a wireless implant was able to release glucagon as an emergency treatment for hypoglycemia, a serious complication of Type 1 diabetes.


Tracy Baroni Allmon, J.D

Latest:

Pressure on Patient Assistance Programs | Predictions for 2025

Predictions for 2025 by Tracy Baroni Allmon, J.D., vice president of Market Access and Policy at Magnolia Market Access.


Eric K. Singhi, M.D.

Latest:

Closing Insights: The Future of Cemiplimab in NSCLC and Beyond

Panelists discuss how, as new data on cemiplimab and other checkpoint inhibitors emerge, the treatment pathway for cancers like non-small cell lung cancer (NSCLC) is expected to evolve toward more personalized, targeted approaches. This will enhance survival outcomes, refine patient selection and optimize therapy regimens.


Carolina Nascimento

Latest:

Digital Transformation is the Revolutionary Change Healthcare Needs

Due to one of the most challenging global crises in living memory and one that presented an acute challenge for the medical community, healthcare providers find themselves operating within an uncertain landscape. They are still managing the fallout of COVID-19 while also planning for the future.


Sobha Pisharody

Latest:

Precision Medicine vs Trial and Error: Why Pharmacogenomics is Increasingly Relevant

Pharmacogenomics looks at how genetic influences affect an individual’s response to therapeutic medications.


Thomas Foley

Latest:

Closing the Gap With Virtual Care Services: Reimagining the Delivery of Healthcare

The delivery of care model needs to scale across the community settings while servicing the unique needs of each patient.


Tom Martin, M.A., MBA

Latest:

CMS’s RADV Strategy Will Reverberate Throughout Health Plan Operations

To prepare for CMS’ new risk adjustment data validation (RADV) strategy, Medicare Advantage plans must take a coordinated, organization-wide approach.


Jaime Rosenberg

Latest:

Study: Medicaid Coverage Uneven for Gene Therapies

Recent study finds that Medicaid coverage for some of the first gene and cell therapies was at times delayed and not consistent with federal requirements.


Nate Allen

Latest:

Digital Patient Engagement: Helping Uninsured Americans Gain Access to Care

Identifying the right payer before a healthcare service is provided and billing on time, reduces costs, prevents bad debt and maximizes reimbursements and revenue.


Solveig Dittmann

Latest:

Acute Hospital-at-Home Holds Promise for Hospitals Facing Staffing Shortages

Organizations setting up hospital-at-home programs need to be aware of the associated risks and mitigation best practices.


Vinay Mummigatti, EVP of Strategy at Skan

Latest:

Reimagining healthcare payer operations: the power of process intelligence

How AI-powered technology and its data-driven insights improve payer operations and reimburse providers faster.


Janet Walker

Latest:

Getting Real About Health Equity

CMS and state officials are using payment incentives, data collection and program requirements to start edging the lofty ideals of health equity toward reality.


Angie Meoli

Latest:

Collaborating to Support Better Outcomes Through Value-Based Care

Engaging with payers in collaborative arrangements is critical for achieving quality outcomes at lower cost, while ensuring financial health for providers during good times and bad.


Jonathan E. Levitt

Latest:

Why Timing Matters When It Comes to PBM Contracting

Plan sponsors should begin evaluation of PBM performance at least a year before the contract expires, say lawyers with expertise in PBM contracting.


Adam Sabloff

Latest:

Health Plans Are Managing More Data Than Ever Before. How to Ensure It’s Usable.

Health plans need to consider regulations and keep healthcare data secure to take full advantage of its enormous potential to broaden and reshape timely, effective delivery of care.



Sebastian Seiguer

Latest:

The Future of the Growing Medication Adherence Market

Patients with chronic conditions like asthma, diabetes, and cardiovascular disease often require emergency attention and hospitalization due to non-adherence, resulting in higher treatment costs.


Joan Kapusnik-Uner, Pharm.D., FCSHP, FASHP

Latest:

Clinical Decision Support Can Help Identify Common Drugs Linked with Increased Arrhythmia and Sudden Death Risk

Research has linked many drugs to QT prolongation and decision support tools could alert clinicians to the risk and guide prescribing decisions to safer alternatives.


Akhilesh Ayer

Latest:

Pharma: Striding Towards the Digital-only Reality with AI

As industries across the board move towards a digital-only world, pharma companies must account for the different technologies that are transforming the R&D process.


Dae Y. Lee

Latest:

Why Timing Matters When It Comes to PBM Contracting

Plan sponsors should begin evaluation of PBM performance at least a year before the contract expires, say lawyers with expertise in PBM contracting.


Ian E. Krop, MD, PhD

Latest:

Value-Based Decision-Making in Metastatic Breast Cancer

In this Managed Healthcare Executive® KCast, Ian Krop, M.D., Ph.D., oncologist and associate professor of medicine at Dana-Farber Cancer Institute in Boston, and Debra Patt, M.D., Ph.D., MBA, executive vice president at Texas Oncology in Austin, provide key insights into the value-based care model for patients with HER2-positive metastatic breast cancer (mBC). This article summarizes the highlights of the discussion.


Jim Jacobs

Latest:

2025 Digital Healthcare Outlook: Compliance, Security and Collaboration

Some regulatory changes are already set to happen this year, but reduced regulation under the new administration could have a ripple effects in healthcare. Meanwhile, artificial intelligence is likely to have pronounced impact on nonclinical workflows in 2025.


Paul Boal

Latest:

How to Recognize, Capitalize on the Benefits of Price Transparency in Healthcare

Hospital leaders who have historically viewed price transparency as potentially disastrous can tap into these three tips to leave that mindset behind and capitalize on the opportunities that price transparency provides.


Michael Pattwell

Latest:

Accelerating Value-Based Care Transformation Today and Post COVID-19

One year into the COVID-19 pandemic and healthcare leaders are taking a hard look at all operations – especially innovative reimbursement models that best meet the needs of their business, providers and patients. No doubt these leaders are finally paying closer attention to value-based care.


Zahra Mahmoudjafari, PharmD, MBA, BCOP, FHOPA

Latest:

Clinical and Practical Comparisons of BCMA-Targeted Therapies in R/R MM

An expert discusses the evolving role of BCMA-targeted therapies in relapsed/refractory multiple myeloma (R/R MM), comparing the efficacy, safety, and logistical considerations of CAR T-cell therapies, bispecific antibodies, and antibody-drug conjugates, and emphasizing the importance of individualized treatment selection and ongoing refinement of therapeutic sequencing.



John Schwartz

Latest:

Exploring the Critical First Step in Adding and Paying CBOs in Value-based Contracts

The transition from treating patients at a provider’s site to delivering care in the home and community requires two things: an ability to incorporate social determinants of health into the care coordination process and the inclusion of value-based care and community-based organizations as compensated care delivery partners in VBC networks.

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