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Rich Priore, Sc.D., M.H.A., a clinical associate professor in the Department of Health Policy and Management at Tulane University addresses how hospitals will be affected on the cost and revenue side after the COVID-19 Public Health Emergency expires May 11.

Cuban, of "Shark Tank' fame and owner of the Dallas Mavericks, called drugs prices ‘insane’ and used some profanity when talking pharmacy benefit managers at the annual meeting of the Association for Accessible Medicines yesterday. Cuban has co-founded an online pharmacy that he says will make drug prices lower and transparent.

The trade association began lobbying in 2019.

Data collected from more than 40,000 practitioners revealed the top healthcare trends that will have the biggest impact on physicians and medical offices in 2023. Among them were patient-centric care, remote patient monitoring and mental healthcare.

Under the Consolidated Appropriations Act of 2023, some Medicare telehealth flexibilities will extend until December 31, 2024, though significant questions remain for the future of telehealth, especially in the Medicare program.

The FDA has approved two pediatric indications this week: Takhyzro for hereditary angioedema and Eylea for retinopathy of prematurity. The agency expanded the label of Cibinqo for atopic dermatitis in adolescents, and granted full approval to Jemperli for endometrial cancer. Additionally, the agency has set PDUFA dates for two drugs: reproxalap for dry eye and zuranolone for depression.

Rich Priore, Sc.D., M.H.A., a clinical associate professor in the Department of Health Policy and Management at Tulane University, said if Americans invested in health prevention and wellness, fewer would be in hospitals and the cost of care would lower.

Several firms are trying to bring the clinical laboratory to patients’ doorsteps, but the task comes with plenty of challenges.

Our guest on this month’s episode of the “What's on Your Mind” podcast is Margaret Murray, M.P.A., founding CEO of the Association for Community Affiliated Plans (ACAP) and a longtime member of Managed Healthcare Executive® editorial advisory board. Murray is an expert on Medicaid and healthcare policies that affect people with low incomes. In the interview with Managing Editor of MHE, Peter Wehrwein, she discusses ACAP’s growth and its legislative wins, Medicaid redetermination, “junk insurance,” and state Medicaid programs carving out pharmacy benefits.

The announcement of the $10.6 billion acquisition comes a few months after the company announced it was buying Signify Health, a home health provider, for $8 billion.

In 2023, CVS executives expect revenue in pharmacy services to grow by 1% to 2% driven by generic and biosimilar launches.

In calling for extending the $35 cap on insulin prices to people with private insurance, the president spoke about big pharma making record profits.

An online condition-based care service designed to help people understand if they meet the criteria for progression to severe COVID-19 was launched under the partnership of Pfizer and Ada Health.

Gastroesophageal reflux disease is a risk factor for what is now the more common type of esophageal cancer, adenocarcinoma. Immunotherapy is coming on strong as a treatment.

The FDA has approved two breast cancer therapies this week: Trodelvy to treat patients with HR+/HER2- breast cancer and Orserdu to treat patients with ER+, HER2-, ESR1-mutated disease. The agency also approved a novel therapy for CKD-related anemia and Tezspire in pre-filled pen.

Evernorth, Cigna’s pharmacy and benefits solutions division, contributed more than 75% of the company’s revenue last year.

François de Brantes, a member of the Managed Healthcare Executive ® editorial advisory board and senior partner at High Value Care Incentives Advisory Group LLC, describes what he believes has caused a major inflection point in the management, delivery and payment of U.S. healthcare

Certain biomarkers identified by these devices can be used to identify survivors of trauma who need further evaluation.

In this month’s episode of Tuning In to the C-Suite, Managing Editor Peter Wehrwein talks with Rick Bates, MBA, president and CEO of RxSense. In his conversation with Wehrwein, Bates described RxSense as a “technology platform company that has expertise in the direct-to-consumer business.” He emphasized that RxSense is not a pharmacy benefit manager (PBM) — but, rather, a company that supplies PBMs with technology, including some of the up-and-coming PBMs, such as EmsanaRx and Vivid Clear Rx. Bates and Wehrwein also discussed the Mark Cuban Cost Plus Drug and RxSense launching a standalone business intelligence product called Rx IQ.

It's been reported more often now that funding for telehealth has decreased and it will only continue to do so into the year. Funding has likely decreased because the video/virtual care medium has become a commodity, according to Summus CEO and Founder, Julian Flannery.

A Swedish and a French company have treatments with novel mechanisms of action in late-stage development. Meanwhile, AbbVie, Janssen and Eli Lilly are vying to get the first interleukin-23 inhibitor for ulcerative colitis on the market.

Larger payers have plenty of cash on hand to do deals but will look for “adjacencies” rather than merger and acquisition with other payers because of the regulatory environment, say Bain experts.

The Risk Adjustment Data Validation (RADV) rule was finalized today. The new rule for governing how CMS audits Medicare Advantage plans for overpayment due to inflated risk adjustment could cost insurers billions of dollars.

Virtual care has been a favored service among many healthcare consumers as its users have shared they want more out of it, according to a 2022 Virtual Care Survey Report by Summus.

Connecting the healthcare system and patients in a positive, empathetic, respectful way may help lessen the fatigue many groups have with the healthcare system at-large and individual healthcare providers, while improving health equity.

As a dozen Humira Biosimilars are set to enter the market this year, it seems to be unlikely that they will drive down drug costs in the future.

The FDA approved a new drug for type 2 diabetes and a new BTK inhibitor for rare blood cancer while Keytruda got another indication in lung cancer. But Evusheld lost its EUA for COVID-19. The agency accepted an sNDA for Jardiance for CKD and officials said they plan to hold advisory committee meeting for Biogen’s ALS drug.

Results from a recent U.S. Department of Health and Human Services (HHS) analysis shared that Medicare beneficiaries who use insulin would have saved $734 million in Part D and $27 million in Part B if these caps had been in effect in 2020