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Here’s what you missed this week on Managed Healthcare Executive.

In a wide-ranging interview, the chief medical officer of the SCAN Group discusses primary care, SCAN's partnership with Sutter and the way healthcare is practiced on the West Coast compared with the East Coast.

Gen Z workers have a less positive outlook about the healthcare field than their older counterparts, according to the results of a new national survey by WellSky.

Vertically integrated health plans are starting to fall by the wayside due to their limited flexibility, while modular health plans are gaining traction, according to Scott Rossignol, senior director of Drug Value Strategy at Abarca Health.

Health Secretary Robert F. Kennedy Jr. faces bipartisan scrutiny over vaccine policies, Medicare costs and rural healthcare during a Senate hearing.

Act 624 and ambiguous ERISA policies are some of the biggest issues faced by pharmacy benefit leaders today, according to Robyn Crosson, vice president of government relations, Navitus Health Solutions.

Pharmacy and medical benefit programs have traditionally operated separately, despite having similarities. Nishi Goel, Pharm.D., vice president of customer experience, Agadia, is trying to change that.

The growing trend of at-home drug administration emphasizes the need for integrated medical and pharmacy reviews, according to Nishi Goel, Pharm.D., vice president of customer experience, Agadia.

Healthcare organizations face ongoing challenges like burnout and inefficiency, but a shift towards integrated technology and collaboration offers hope for improvement.

Proposed premium increases in the ACA Marketplace for 2026 surge due to rising healthcare costs, specialty drug prices and subsidy uncertainties, according to a recent KFF analysis.

Experts criticize the FDA's narrow COVID-19 vaccine approval, warning it limits access and undermines public health amid rising hospitalization rates.

With healthcare costs climbing, Stuart will lead the nonprofit insurer’s push to keep coverage affordable for 6 million Californians.

Although Medicare Advantage plan member satisfaction has dropped, areas for improvement have emerged in the form of digital innovations, according to the J.D. Power 2025 U.S. Medicare Advantage Study.

Here’s what you missed this week on Managed Healthcare Executive.

The next step for the Rise For Health study researchers is to study the health benefits of frequent standing in older men and women.

Sexual and gender minority individuals still face insurance denials and cost-sharing barriers when accessing pre-exposure prophylaxis (PrEP), despite having a Grade A recommendation from the United States Preventive Services Task Force (USPSTF).

The biosimilar will be available to any licensed specialty pharmacy in the United States at a 95% discount from Stelara, starting January 1, 2026.

Large language models (LLMs) were more likely to suggest inferior treatment options when reviewing hypothetical cases when patients' Black identity was listed or implied.

New study results provide insight into improving heart health through behavior changes, such as taking standing breaks throughout the day.

A lack of training and vague, overlapping symptoms can be attributed to more than three-quarters of autoimmune patients being misdiagnosed at least once, according to Veena Joy, the U.S. Lead for Strategic Partnerships, Allergy and Autoimmunity at Thermo Fisher Scientific.

This recent study underscores the fact that biomarkers serve not merely as statistical instruments but as insights into disease biology.

In an analysis from Trilliant Health of 11 inpatient and outpatient procedures, Aetna and UnitedHealthcare had huge variations in rates across the country, across states, and even at the same facility for the same procedures.

Prefilled syringes of Imuldosa now have the lowest wholesaler acquisition cost among all branded ustekinumab biosimilars, according to a news release.

Tonmya is the first new fibromyalgia treatment approved by the FDA in more than 15 years, providing symptom relief for at least 30% of patients when compared to placebo, according to clinical trial results.

Here’s what you missed this week on Managed Healthcare Executive.

Papzimeos is the first and only FDA-approved treatment for adults with recurrent respiratory papillomatosis (RRP), with ongoing clinical studies showing symptom relief for up to two years.

This final part of the three-part video series highlights Sharon Faust of Navitus reflecting on how personal challenges, including her husband’s accident, reshaped her perspective and empowered her to lead boldly in the PBM industry.

Those with hemophilia face heightened risks of depression and anxiety due to pain and joint issues, impacting their overall mental health and quality of life.