With multiple stakeholders involved with different interests, the “specialty drug” definition can be a moving target.

Consistent with the approach taken by other alternative payment models, GUIDE frames the emergency department as a negative ...

Community health needs assessments identify key health needs and issues, but historically have not included sufficient data ...

The 2023 national health care spending study's authors, who are with the Centers for Medicare and Medicaid Services' Office of the Actuary, discussed the CMS data with members of the news media. The ...

Under the current Medicare Advantage (MA) risk-adjustment system, plans are incentivized to report diagnosis codes on enrollees’ medical claims reflecting additional and more severe health conditions ...

More than a dozen years after its enactment, policy and legal disputes related to the Affordable Care Act (ACA) remain.

Health care spending in the US reached $4.9 trillion and increased 7.5 percent in 2023, growing from a rate of 4.6 percent in 2022. In 2023, the insured share of the population reached 92.5 ...

The Food and Drug Administration (FDA) Breakthrough Devices Program was created by the Congress in the 21st Century Cures Act of 2016. The program is designed to accelerate the development ...

In recent years, policymakers, regulators, and litigants have increased their focus on the practices of pharmacy benefit managers (PBMs) in response to the high cost of prescription drugs.

Each year Health Affairs publishes retrospective National Health Expenditure (NHE) data from the National Health Expenditure Accounts (NHEA) team at the Centers for Medicare and Medicaid Services ...