A new analysis from the Congressional Budget Office (CBO) warns that Republicans’ massive tax bill could lead to hundreds of billions in cuts to Medicare over the next 10 years. CBO analysts, in a letter (PDF) to key Democratic senators Friday, dug into the potential impact the One Big Beautiful Bill Act could have on federal programs ...

As the Trump administration moves forward with sweeping tariffs aimed at increasing U.S. manufacturing, health systems are ramping up efforts to protect patients from potential effects. At Renton, Wash.-based Providence, COO Darryl Elmouchi, MD, said the health system has implemented a supply chain risk management program to help prepare for challenges with respect to tariffs. ...

National pricing data show the cost of healthcare services varies greatly by payer, geography, setting and facility, presenting new fiduciary considerations for employers. Since 2022, health plans have been required to release machine-readable files disclosing negotiated rates of healthcare services with providers. Hospitals are also required to release the costs of shoppable services. Data analytics ...

The Affordable Care Act (ACA) introduced Medical Loss Ratio (MLR) requirements for fully insured medical plans. These rules require insurers to spend a substantial portion of premium dollars on actual health care services and quality improvements. In turn, they limit the dollars that can go toward administrative costs like marketing, salaries, agent commissions, and profits. The MLR ...

Amid pressure from the White House, U.S. drug companies are experimenting with direct-to-consumer sales models that cut out the middlemen.

The partnership between GoodRx and Novo Nordisk represents a seismic shift in the diabetes drug sector, redefining pricing power and market access for GLP-1 receptor agonists (GLP-1RAs). By slashing the cash price of Ozempic and Wegovy to $499 per month for self-paying patients, the collaboration not only addresses affordability gaps but also positions both firms ...