Healthcare Central

  • States brace for sweeping Medicaid work requirement 

    Medicaid work rules are coming. Can states handle it? Moderator: Joanne Kenen, journalist-in-residence at Johns Hopkins Bloomberg School of Public Health Hemi Tewarson, president and executive director of the National Academy for State Health Policy Kirsten Johnson, secretary for Wisconsin Department of Health Services  By Jaymie Baxley/North Carolina Fellow Medicaid beneficiaries in states that expanded…

  • GLP-1s are different for older adults

    Part 1 of this story looked at changes to the BRIDGE and BALANCE programs, CMS initiatives that were developed to give Medicare and Medicaid beneficiaries access to GLP-1 treatment for obesity. CMS paused the BALANCE program on April 20, citing lack of insurer participation. The agency is instead extending its Medicare GLP-1 Bridge pilot program…

  • Policy experts offer differing views on health care for all at HJ26 

    Health care for all: Dream, nightmare or one big muddle? Moderator: Jonathan Cohn, Reporter and author, The Bulwark Jeanne Lambrew, Director of health care reform and senior fellow, The Century Foundation Chris Pope, Senior fellow, Manhattan Institute The Affordable Care Act turns 16 this year, and Medicaid covers nearly 70 million low-income Americans. The Trump administration…

  • Medicare and Medicaid will cover weight-loss drugs next year

    Many people on Medicare and Medicaid who wanted to take GLP-1 drugs for weight loss but couldn’t afford the high prices of these medications were awaiting the launch of the CMS BALANCE Model in 2027.  Those Medicare and Medicaid members were waiting because CMS pays for certain GLP-1s to treat diabetes and heart disease, but…

  • Report: Health disparities are set to widen, again

    A new report from The Commonwealth Fund delivers a clear message: the U.S. health system is backsliding. After a brief period of improvement in access to care and fewer racial and ethnic health disparities in every state, the environment under current state and federal health policies is likely to make those disparities worse, the report…

  • AI is shaping medical coverage decisions. Here’s how to tell the story

    Whether a health insurer denies or approves a medical procedure, there’s a good chance AI was involved in the review. Increasingly, insurers are using artificial intelligence for prior authorization, concurrent review and retrospective and utilization review — terms MedCity News recently defined in an overview of utilization review.  “AI is in all of them,” said…

  • How high-deductible health plans can harm patients’ health

    High-deductible health plans are increasingly common — and research shows they may lead patients to delay or skip needed care. The percentage of Americans under age 65 enrolled in high-deductible health plans ranges from about 42%, according to CDC data, to as high as 58%, according to a study published last year in JAMA Network…

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