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| Oct 19, 2026 | Sunlight AI launches with $17.4M in seed funding to help independent physicians cut administrative costs | Sunlight AI has launched with $17.4 million in announced seed funding to help independent medical practices cut administrative costs and avoid the grip of large hospital systems. The New York- and Miami-based startup is betting that artific... |
| Jul 19, 2026 | Copay assistance is meant to defray patient drug costs. Some insurers keep it instead | Getting your Trinity Audio player ready...
By Daniel Chang, KFF Health News
For 16 years, Larry Gruber, a fitness coach from Wilton Manors, Florida, received a coupon card to help him pay for a psoriatic arthritis medication he needs that c... |
| Jul 14, 2025 | Trump's spending bill will likely boost costs for insurers, shrink Medicaid coverage | Trump's spending bill will likely boost costs for insurers, shrink Medicaid coverage
By Amina NiasseJuly 14, 202510:19 AM UTCUpdated ago
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U.S. President Donald Trump... |
| Apr 2, 2025 | Rural America Loses Independent Physicians and Practices at Alarming Rate, Report Finds | Source: Image by freepik
What You Should Know:
– A new report commissioned by the Physicians Advocacy Institute (PAI) and conducted by Avalere reveals a significant decline in the number of independent physicians and medical practices in ru... |
| Jan 15, 2025 | Health | Health insurers limit coverage of prosthetic limbs, questioning their medical necessity | To people in the amputee community, the coverage disparity amounts to discrimination.
“Insurance covers a knee replacement if it’s covered with skin, but if it’s covered with plastic, it’s not going to cover it,” said Jeffrey Cain, a family... |
| Aug 7, 2024 | Politics | Harris’ California health care battles signal fights ahead for hospitals if she wins | For decades, the health industry has undergone consolidation despite government efforts to maintain competition. When health systems expand, adding hospitals and doctor practices to their portfolios, they often gain a large enough share of ... |
| Jun 5, 2024 | 340B reform efforts pick up steam | figcaption>span]:font-sans">
Momentum is building on both sides of the Capitol to make comprehensive changes to the federal 340B drug discount program — though it's unclear how much money the plans would save.
Why it matters: Sur... |
| Apr 25, 2024 | GOP jumps on chance to bash Biden on Medicare | figcaption>span]:font-sans">
Republicans are needling the Biden administration over a recent cut to Medicare plans, indicating a fight over the program's future could play a bigger role in this year's election.
Why it matters: Wh... |
| Feb 21, 2024 | Congress eyes another pass at 340B reform | An overhaul of the 340B drug discount program is again tempting some lawmakers on the Hill, despite an already formidable health care to-do list.
Why it matters: The program has been a magnet for conflict, drawing drugmakers, hospitals and ... |
| Nov 3, 2023 | State Prescription Drug Affordability Boards could end up limiting access to the life-saving cystic fibrosis medication Trikafta | I was living on the precipice of end-stage disease when I enrolled in the clinical trial that resulted in the historically fast Food and Drug Administration approval for the game-changing cystic fibrosis drug Trikafta. Five years later, the... |
| Jun 13, 2023 | The billion-dollar rule that has hospitals on edge | Safety net hospitals will soon learn how the government plans to reimburse them for nearly $10 billion resulting from underpayments from the federal drug discount program. The question is whether it will come at the expense of other hospita... |
| Jan 23, 2023 | How Will The Inflation Reduction Act Impact Healthcare in 2023? 6 Trends to Know | What You Should Know:
The main insights from the report are highlighted as follows:
1. Understanding the Interaction Among New Drug Pricing Policies
Drug pricing policy changes will have far-reaching effects for all stakeholders, varying ba... |
| Dec 16, 2022 | Analysis Shows Inflation Reduction Act Will Lead to At Least 49.5% Cut to Cancer Providers Part B Add-On Reimbursements | COA warns Medicare add-on reimbursement cuts in IRA will place extreme pressure on independent practice operations and calls on Congress to act
If the IRA cuts become reality, it will decimate the nation’s cancer care system, threaten patie... |
| Jul 29, 2022 | Which drugs may be hit with negotiations if the reconciliation bill passes? Wall St. analysts explain | Beyond the back and forth of whether Democrats’ drug price negotiation plan is necessary to bring down costs, or just a thinly veiled attempt at price controls, the nuts and bolts of the deal mean pharma companies will inevi... |
| May 4, 2022 | Community Oncology Alliance Announces Committee Focused on Improving Health Equity | Community Oncology Alliance Logo
Health Equity Committee Will Lead COA’s Efforts to Address Cancer and Other Health Disparities Through Research and Projects WASHINGTON, D.C., UNITED STATES, May 4, 2022 /EINPresswire.com/ -- As part of its ... |
| Dec 15, 2021 | This Holiday Season, Let’s Appreciate the Difference Health Makes | (BPT) - The new year invites us to recognize what’s really important. As many families gather for the first holiday season back together, the value of health takes precedence over the packages under the tree. And as we make our resolutions,... |
| Dec 9, 2021 | BrightStar Care Demonstrates Impact of Personal Care Services on Health Care Utilization in Latest Analysis by Avalere | GURNEE, Ill. (PRWEB) December 09, 2021
BrightStar Care, a nationwide franchise that provides a higher standard of quality in-home care, released key findings today from an analysis conducted by Avalere Health, a leading US-based healthcare ... |
| Jul 26, 2021 | GlaxoSmithKline : Shingrix approved in the US for prevention of shingles in immunocompromised adults | For media and investors only
Issued: Philadelphia, London
GlaxoSmithKline plc today announced that the US Food and Drug Administration (FDA) has approved Shingrix (Zoster Vaccine Recombinant, Adjuvanted) for the prevention of shingles (herp... |
| Jul 6, 2021 | Stop The Bid To Expand Medicare | US Senator Bernie Sanders, Independent of Vermont, speaks to pro-immigration activists from ... [+] organizations including CASA and the Center for Popular Democracy, as they hold a "WeCantWait" march to urge Congress to act on im... |
| Jun 28, 2021 | Biden won’t end cancer — or any other disease — by importing drug price controls from Europe | In his first budget, President Biden set aggressive health goals. “Let’s end cancer as we know it,” he said to rousing applause in a speech to Congress. “It’s within our power. It’s within our power to do it.”
Cancer is not all Biden wants ... |
| Jun 22, 2021 | 5 Blues plans launch pharmacy solutions startup Evio | Five Blue Cross Blue Shield plans have joined forces to establish Evio, a new independent pharmacy solutions startup.
The for-profit startup aims to rein in drug costs and improve clinical outcomes.
The founding insurers, who invested the s... |
| Apr 29, 2021 | Top 5 Medicare Advantage plan changes coming for 2022 | While some of the changes in the 2022 final rule had been announced before Covid-19, several updates, particularly to the payment growth rate, were unexpected. The following are the top 5 changes in the MA and Part D final rule for 2022.
Ef... |
| Apr 22, 2021 | Implications for the Affordable Care Act under the Biden administration | While broad changes may be off the table, incremental changes that strengthen the law, especially those that have bipartisan support from Republicans, are quite likely. Presenting to the virtual assembly of the J.P. Morgan Healthcare Confer... |
| Apr 12, 2021 | Sanders Proposal Brings Medicare Closer To The Brink Of Collapse | WASHINGTON, DC - FEBRUARY 25: Senator Bernie Sanders (I-V.T.), Chairman of the Budget Committee, ... [+] arrives to a U.S. Senate Budget Committee hearing regarding wages at large corporations on Capitol Hill. (Photo by Stefani Reynolds-Poo... |
| Dec 11, 2020 | Trump’s ‘most favored nations’ experiment undermines care for millions covered by Medicare | President Trump and other administration officials have talked a big game about their new most favored nation model for lowering prices for Medicare Part B drugs, including cancer therapies and other potentially lifesaving treatments admini... |
| Nov 9, 2020 | Biden His Time On Health Care? | WILMINGTON, DELAWARE - NOVEMBER 05: Democratic presidential nominee Joe Biden waves to a crowd ... [+] gathered outside of The Queen theater on November 05, 2020 in Wilmington, Delaware. Biden attended internal meetings with staff as votes ... |
| Sep 17, 2020 | Racial disparities during pandemic extend to health coverage losses | Sign up for our daily briefingMake your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.
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| Sep 16, 2020 | Trump’s ‘most favored nation’ executive order on drug prices is a scam for seniors | The White House announced a most favored nations executive order on Sunday, its latest attempt to lower prescription drug costs in the U.S. The new policy, which relies on international price competition, promises to provide Americans with ... |
| Sep 15, 2020 | Racial Disparities And Renal Dialysis: Aligning Payment Systems With Health Equity | |
| Jun 16, 2020 | COVID-19, Recession And Racial Disparities: A New Agenda For America’s Health Plans | At the start of 2020, Americans’ primary healthcare concern was the affordability of care – focused largely on prescription pharmaceuticals and other unpredictable expenses. The landscape has now changed profoundly. The COVID-19 pandemic, e... |
| Oct 17, 2019 | Pelosi’s drug pricing plan puts medical innovation at risk | The future of medical innovation in America is at a crossroads.
Biopharmaceutical science is accelerating at a record pace, leading to new discoveries that are radically reshaping our ability to fight disease. At the same time, politicians ... |
| Mar 2, 2018 | Without congressional action, insurers say premiums will go up in 2019 due to uncertainty | They hope to attach a package of fixes to what should be the year’s final temporary spending bill, due in late March.
The lawmakers are up against not just the legislative clock, but also the insurance companies’ timeline. Insurers have unt... |
| Sep 21, 2017 | Column:: The disastrous impact of the GOP’s Obamacare repeal plan, in three devastating charts | The healthcare consulting firm Avalere on Wednesday released the latest in a series of independent analyses of Senate Republicans’ new effort to repeal the Affordable Care Act. The findings are beyond ugly. They show devastating cuts in hea... |
| Aug 2, 2017 | New online navigator helps patients and doctors access experimental treatments | When approved therapies don’t work, or stop working, for people with serious or life-threatening illnesses, it puts them in a difficult position. Some turn to clinical trials that are testing experimental treatments. But many can’t do that ... |
| Jul 13, 2017 | 'Everything is in jeopardy' for children who count on Medicaid, and that's turning their parents into activists | Courtesy Marlee Stefanelli
Marlee Stefanelli with her children, Matthew (who has Type 1 diabetes) and Isabella.
Medicaid, a federal and state program that insures 74 million Americans, faces funding cuts under the Republican healthcare plan... |
| Nov 8, 2016 | Novel system to get dying patients an experimental cancer drug raises hopes — and thorny questions | The drug was still experimental, but clinical trials suggested it could be a lifesaver for patients with a lethal form of blood cancer called multiple myeloma.
And those patients were clamoring to get it. They overwhelmed drug maker Janssen... |
| Oct 19, 2016 | Stop insurers from making end runs around patients with preexisting conditions | For years, insurers dropped sick people from their plans or denied coverage due to preexisting conditions like cancer, keeping them from the care and medicines they needed. The Affordable Care Act (ACA) was supposed to make it unlawful for ... |
| Oct 11, 2016 | What experimental drug? Most companies don’t post compassionate use policies | As patients clamor for greater access to experimental medicines, a survey released Tuesday finds that just 19 percent of 100 drug makers publicly post policies about their programs for obtaining these drugs, which are known as compassionate... |
| Aug 16, 2016 | Pharmalot, Pharmalittle: Vertex ends a late-stage cystic fibrosis study | Good morning, everyone, and how are you today? We are just fine, thank you, despite another steamy day unfolding here on the Pharmalot campus, where the short people and the official mascots are all sleeping in. As for us, we are quaffing c... |
| Jul 26, 2016 | New tools for assessing drug value haven’t caught on with payers — yet | As prices for prescription drugs keep rising, several organizations have developed different ways to assess the value of new medicines based on such attributes as cost, quality of life, and effectiveness. But a new survey finds that even as... |
| Apr 18, 2016 | Unintended twist in Obamacare may cost some Medicare patients more for biosimilars | An “unintended consequence” of the Affordable Care Act may mean that Medicare Part D beneficiaries will pay more for biosimilars than for costlier brand-name biologics, according to a new analysis released last week.
The reason is that the ... |
| Aug 26, 2015 | Inovalon to Acquire Avalere Health for $140M | Inovalon (Nasdaq: INOV), a technology company providing advanced cloud-based analytics and data-driven intervention platforms to the healthcare industry, is to acquire Avalere Health, Inc., a Washington D.C.-based provider of data-driven ad... |
| Aug 8, 2014 | All eyes on Vermont as it blazes a single-payer trail | It’s that getting there seems so fraught with complexity. “The problem is that the tentacles of our completely dysfunctional U.S. health system reach so deeply into every state,” he said. “How do you disentangle from that abysmal structure ... |
| Aug 1, 2014 | Florida’s largest health insurer is raising rates more than 17% for plans on the exchange | Florida Blue offers many plans. The 40 percent of its individual policyholders who chose “narrow network” plans called BlueSelect that limit coverage to fewer doctors and hospitals will see rates rise by an average of 13 percent.
Critics of... |
| Patients and innovation at risk with Pelosi plan | Speaker of the House Nancy Pelosi’s recently unveiled drug pricing legislation, H.R. 3, would restrict and fundamentally change how patients access medicines in the United States. It would threaten our country’s global leadership in develop... |
| Implications for the Affordable Care Act under the Biden administration | Few would have predicted the world-changing events of 2020. Predicting the fate of the Affordable Care Act (ACA) over the next four years under President Biden seems untenable given how much uncertainty we have lived with. Even so, there is... |
| New analysis reveals alarming drop in vaccinations for teens and adults over the past year | By Judy Stewart
As if we needed another thing to worry about during this time of a pandemic, a new analysis reveals a significant and alarming drop in recommended vaccinations for teens and adults.
The Covid-19 Pandemic: Impact on US Adoles... |
| All eyes on Vermont as it blazes a single-payer trail | BERLIN, Vt. – Dr. Marvin Malek has been yearning and advocating for a publicly financed, single-payer health care system for at least two decades. Now, as Vermont stands on the threshold of being the first state to launch such a plan, he’s ... |
| JPMorgan Chase launches new health-care business after winding down Amazon-Berkshire venture | JPMorgan is launching Morgan Health to improve the quality of medical care for the bank’s 165,000 U.S. employees and their families.
The business will be led by Dan Mendelson, a health consultant who served in the Clinton administration.
Th... |
| Without congressional action, insurers say premiums will go up in 2019 due to uncertainty | Close up view of the intricate detail of the U.S. Capitol Rotunda ceiling and silhouette of George Washington.
Congress is running out of time if members want to come up with legislation to stabilize the individual insurance market.
While R... |
| Top 5 Medicare Advantage plan changes coming for 2022 | Covid-19 overwhelmed hospitals in many metropolitan areas in 2020, and patients hospitalized with the virus often had a longer length of stay compared to other conditions. Healthcare costs overall, however, are expected to be anywhere from ... |
| 5 Blues plans launch pharmacy solutions startup Evio | Five Blue Cross Blue Shield plans have joined forces to establish Evio, a new independent pharmacy solutions startup.
The for-profit startup aims to rein in drug costs and improve clinical outcomes.
The founding insurers, who invested the s... |
| How a simple fix to Medicare Part D could save seniors and the U.S. healthcare system billions | Prescription drug costs and access to generics have become leading debate topics among policymakers, pundits and healthcare providers alike — and at the heart of this conversation are America’s seniors.
Today, more than 43 million seniors r... |
| ‘Caught in the middle’: A battle between Vertex and insurers is leaving cystic fibrosis patients with crushing drug costs | Dan Brickey was stunned when he learned the news.
The cost of the cystic fibrosis medicine that his 2-year-old daughter, Ali, had recently started taking was about to climb from just $180 out of pocket each year to a whopping $43,600 in 202... |
| Florida’s largest health insurer is raising rates more than 17% for plans on the exchange | Florida Blue, the state’s largest health insurer, is increasing premiums by an average of 17.6 percent for its Affordable Care Act exchange plans next year, company officials say.
The nonprofit Blue Cross and Blue Shield affiliate blames hi... |
