Medical management comes to the forefront

Bill Kerr of Avalon Heath Solutions says incorporating Z codes into CPT codes for lab and genetic testing would add needed specificity, reduce waste and possibly head off fraud.

States have to turn that information into medical frailty determinations that are clinically credible, consistent, and workable across large Medicaid populations.

A meta-analysis found steatotic liver disease in 75% of patients with sleep-disordered breathing and that CPAP lowered liver enzymes but not liver fat.

Some predicted that drugmakers might boost launch prices to make up for Medicare drug negotiations shrinking profits. Harvard researchers find no evidence of that happening so far.

State PBM reform accelerates through 2026, with Theresa Carnegie of Mintz unpacking new laws, rebate pass-through, spread pricing bans, and compliance risks.

Only 19.1% of commercially insured patients with first-episode psychosis were adherent to antipsychotics in the year after starting treatment.

Prioritizing referral completion as much as referral generation will equip organizations to measure results and improve health outcomes.

Daiichi Sankyo and Merck pulled their bid for accelerated approval of I-DXd in small cell lung cancer after the FDA found phase 2 data fell short.