Jenny Goins, interim head of the National Alliance of Healthcare Purchaser Coalitions, says employers need the same visibility into medical benefits that a new Department of Labor rule gives them into PBM compensation.
Only 19% of community oncologists use AI predictive models. Prerna Mewawalla, M.D., outlines six ways AI can already help in myeloma care.
Model N's Jesse Mendelsohn explains why drug manufacturers argued that a 340B rebates instead of upfront discounts will avoid an overlapping maximum fair price and 340B discounts
The PHOTON trial showed that higher-dose therapy maintained visual and anatomic gains with markedly fewer injections. The panel reviews trial design, durability outcomes, and the cost analysis built on those data.
Longer treatment intervals can renew patient engagement and improve adherence. Dr. Patel explains how he weighs safety, efficacy, and early anatomic response when selecting an anti-VEGF agent for DME.
People with ADHD had a 70% higher risk of death from any cause in a 19-study meta-analysis, with excess deaths from suicide, injury and natural causes.
Fifteen years after HCCI's first report on healthcare cost, CEO Katie Martin says prices, not utilization, are still pushing healthcare costs higher in the employer-insured market.
Topical therapies can be used as maintenance to prevent new lesions, such as long-term low-dose topical clindamycin, Porter said, and topical JAK inhibitors such as ruxolitinib [sold under the brand name Opzelura] are being studied.
Telling patients that being overweight or smoking caused their HS puts the responsibility back on them and has created barriers to seeking and staying in care, Porter said.
Geisinger Health Plan President Jeremy Gaskill says the possibility that a growing number of patients won't have health insurance could put tremendous financial pressure on the plan's providers.
Christopher Stanley, M.D., MBA, says Henry Ford Health now projects its 2027 employee healthcare insurance premiums to increase half as much as what had been expected, partly because of Populance’s to bring about cost-effective care.
Each exacerbation increases a patient's risk of future flares, creating a self-reinforcing cycle that underscores the value of consistent self-management between office visits.
Clinicians have only four limited categories of tools for non-cystic fibrosis bronchiectasis, with little evidence for preventing exacerbations, and the resulting hospitalizations can be lengthy, resource-intensive, and recurrent.
Annesha White, Pharm.D., M.S., Ph.D., and Fredrick Manasseh, Pharm.D., MBA, BCGP, explain where AI helps managed care pharmacy, where bias creeps in and what skills pharmacists need to oversee it.
Unifying care management doubled patient outreach with the same staff, and virtual physical therapy is cutting costs, says Populance's Christopher Stanley, M.D.
Christopher Stanley, M.D., MBA, says Henry Ford Health's growth has led Populance to put its push for outside customers on hold and focus on its own system.
Rising drug prices, limited plan coverage, prior authorization demands, and denials all constrain DME care. Dr. Patel describes how retina practices work to secure the most effective therapy for patients.
Patients with DME often return with advanced disease after missing visits. The panel examines how frequent injections, work obligations, and competing health needs create a cycle of lost follow-up and poorer visual outcomes.
Geisinger Health Plan President Jeremy Gaskill says being owned by a health system aligns incentives, cuts payer-provider busywork and speeds care to patients.
Geisinger Health Plan expects Medicaid enrollment to fall roughly 10% as H.R. 1 takes effect, President Jeremy Gaskill says, though the timing is still unclear.
As other insurers pull back, Geisinger Health Plan isn’t exiting any Medicare Advantage plans for 2027 and expects to grow, President Jeremy Gaskill says.
Hidradenitis suppurativa diagnosis is a clinical diagnosis based on typical lesions in typical locations, such as the axilla, groin and buttocks, along with a pattern of chronicity, Porter said.
The “hidradenitis” in hidradenitis suppurativa means inflammation of apocrine glands, but it took more than 100 years to realize that was a misnomer and that it is actually a disease of hair follicles, Porter explains.
Christine Johnston says Medicaid plans have embraced biosimilars faster than commercial plans and challenges the idea that more expensive means better.
After more than 20 years at Humana, Jeremy Gaskill now leads nonprofit Geisinger Health Plan. The problems are the same, he says, the scale for solving them differs.
Christine Johnston warns a thin biosimilar pipeline keeps specialty costs high and slows innovation and urges payers to check their PBM’s top 25 drugs.
Chronic neutrophilic inflammation, driven in part by neutrophil elastase, is strongly linked to exacerbation frequency in bronchiectasis, and current therapies offer little ability to target that inflammatory pathway directly.
Bronchiectasis causes permanent dilation of the bronchial airways that leads to chronic mucus retention, inflammation, and infection, with exacerbations representing the disease's highest clinical and patient burden.
Anti-VEGF therapy remains the standard of care for center-involved DME, yet eye care competes with dialysis, amputations, and other demands. Dr. Patel explains how disease severity should guide scheduling priority.
Diabetes drives the nation's costliest chronic disease burden, and retinopathy affects most patients over time. The panel outlines the scale of DME and why its economic consequences extend well beyond the eye clinic.
