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A pediatric IBD patient’s medication denial due to lack of pediatric FDA labeling prompted physician-led advocacy, resulting in a state law mandating insurance coverage for pediatric medications with adult approval and supporting data
Medicaid expansion under the Affordable Care Act is associated with reduced mortality in patients under 65 diagnosed with colorectal cancer and synchronous liver metastasis, notably improving outcomes for those receiving surgical and system
This review synthesizes claims-based evidence revealing $106.7 billion US injury spending in 2022, highlighting mechanistic, demographic, and payer-specific spending patterns with implications for trauma system design and health policy.
A historical analysis reveals that policy decisions, financial incentives, and for-profit dialysis centers have contributed to persistent underuse of home dialysis in the US, especially among marginalized populations.
A Medicare-based study found the Oncology Care Model did not increase systemic therapy starts for newly diagnosed cancer and was linked to less treatment initiation and lower spending in poor-prognosis cancer.
A 2010-2023 analysis found that CMS enforcement against Medicare Advantage plans was highly variable, usually limited to modest monetary penalties, and more common among lower-rated contracts serving more socially vulnerable beneficiaries.
The American College of Physicians urges major reforms to Medicare Advantage, including more accurate payment, simpler quality measures, tighter oversight of marketing and prior authorization, and stronger transparency to better protect ben
Telemedicine is no longer an emergency workaround. New policy guidance shows how virtual care can improve access, but only if payment, safety, equity, and prescribing rules evolve carefully.
In a large Medicare study, hospitals under Maryland’s global budget model showed modest but significant improvements in cancer surgery outcomes, driven by fewer complications and shorter stays, with lower inpatient spending.
This review analyzes ophthalmic drug shortages from 2001 to 2024, revealing that eye medications face longer shortage durations than other drug classes, significantly influenced by patent status and manufacturing transparency.
This review synthesizes findings on how Medicaid expansion timing influenced surgical resection rates and 2-year mortality for pancreatic cancer, revealing significant survival benefits alongside persistent socioeconomic disparities.
This review synthesizes population-level data on the eligibility for GLP-1RAs, SGLT2is, and nsMRAs, highlighting that over 60% of US adults meet indications for these transformative therapies.
This review synthesizes recent evidence on the financial impact of CMS billing reforms in hernia surgery and the efficacy of regional collaboratives in improving colorectal cancer outcomes.
A large-scale analysis of 6,026 pediatric heart transplant candidates reveals that status exceptions often prioritize patients with lower mortality risk than those meeting standard criteria, highlighting a significant misalignment in the U.
A 30-year analysis reveals that 10.6 million children experience serious health-related suffering annually, with a massive shift toward chronic, non-decedent care needs in low- and middle-income countries.
This study reveals that young adults with childhood-onset complex chronic conditions (4Cs) account for over 10% of hospital bed-days despite being a small patient volume. They face longer stays, higher costs, and frequent readmissions, high
