Highmark expands drugs offered to members through CivicaScript
Pittsburgh-based insurer Highmark is further expanding its drug offerings through CivicaScript and leaning on biosimilars as pharmaceutical costs continue to...
State-Based Efforts Will Provide Limited Relief from Enhanced Tax Credit Expiration
After failed Senate votes late last year and no subsequent bipartisan agreement, the enhanced premium tax credits expired as of January 1. Some states, particularly those operating...
Industry Voices—FQHCs bridge specialty care’s missed connections
The challenge in community health isn’t just providing access to specialists; it’s also bridging the gap between primary and specialty...
How Unaffordable is Health Care?
In his latest JAMA Forum column, KFF’s Larry Levitt explores how unaffordable health care is in the U.S. in the...
Smarter Choices for Better Health
As we enter 2026, many of us hope that the year ahead will be better, healthier, and more fulfilling than...
Legislators revive ACA debate, Trump seeks meeting with insurers
With Congress back in session this week, the debate over what’s next for the Affordable Care Act (ACA) and its...
Case study: How MetroHealth increased monthly authorizations by 173%
Challenge: Manual authorizations couldn’t scale with demand Manual workflows were no match for MetroHealth’s growing prior authorization demands. With more...
First-Year Rural Health Fund Awards Range From Less Than $100 Per Rural Resident in Ten States to More Than $500 in Eight
On December 29, 2025, the Centers for Medicare & Medicaid Services (CMS) announced first-year state awards from the $50 billion...
When Looking Healthy Isn’t Enough
We often judge health by appearance. If someone is slim and reasonably active, we assume they are doing fine. But...
CMMI proposes new models to lower drug prices in Parts B, D
The Medicare Innovation Center has proposed two drug pricing models that would lower the cost of certain drugs to reflect...
