Value-Based Care

CMS is adding value-based care (VBC) risk faster than many providers can build the data and tech capacity they need to succeed.

AASM urges CMS to reject proposed 2027 Medicare conversion factor cuts of 1.19% to 1.68% and revise sleep testing and remote monitoring policies.

Sustainable models require asking what a result shows, what design produced it, and whether the design was built to measure value or just produce a number.

CAR T-cell therapy must be treated as a complete "vein-to-vein" episode, with community practices needing to take control of cases for a period of time.

Experts tackled CAR T access, trial equity, and overtreatment in breast cancer at an AJMC Institute for Value-Based Medicine event in San Francisco.

CDC's David A. Siegel, MD, MPH, on rising cancer diagnoses, falling deaths, and where CDC's cancer control resources go next.

Prior authorization and compounded drugs remain top obesity care access barriers, says NYU Langone's Holly Lofton, MD.

Panelists say IRA, Most Favored Nation rules and fragmented data are freezing value-based deals for durable one-time therapies.

Payers say NCCN guideline concordance sets a baseline for cancer coverage, but cost and formulary variation may still limit access.

All 50 states have applied for CMS's GENEROUS Model, a Medicaid drug pricing program expected to save $64.3 billion over the next decade.

Geeta Nayyar, MD, MBA, says AI's real health care payoff is cutting administrative friction with clean data and clinical leadership.

Oral GLP-1s, Medicare access, and lingering weight bias are reshaping obesity care, says NYU Langone's Holly Lofton, MD.

Community oncologists are steadily adopting bispecific antibodies for myeloma, but advance planning and tocilizumab remain key to safe access.

Experts discuss what SCAN Health Plan's new Medicare Advantage (MA) partnership with Costco could mean for beneficiaries, competition, and costs.

Poor cardiovascular health, especially high BMI and poor sleep, is linked to a substantially higher risk of overactive bladder, new data show.

Pulmonary experts detail bronchiectasis care gaps, multidisciplinary strategies, and steps toward Care Center Network designation and standardized care.

FDA clears Roche and Eli Lilly's first blood test to both rule in and rule out amyloid pathology in Alzheimer disease.

The third-gen PCKS9 inhibitor was approved in December 2025 as adjunctive treatment alongside diet and exercise for adults with hypercholesterolemia.

Arshad Khanani, MD, weighs Wnt- and Tie2-targeting agents against gene therapy and makes the case for payers to look past price to long-term value.

A gene tied to poor sarcoma prognosis also rose fastest in pazopanib-sensitive sarcoma cell lines, a new exploratory study suggests.

Arshad Khanani, MD, explains why gene therapy for wet age-related macular degeneration (AMD) is close to becoming a real-world option for the masses.

Experts at the Washington, DC, Pop Health Roundtable discussed delays in ILD diagnosis, multidisciplinary care, antifibrotic therapy, and insurance barriers.

Peter Forsberg, MD, discusses referral pathways, payer barriers, and expanding access to CAR T-cell and bispecific therapies.

Steven D. Nathan, MD, discusses how multidisciplinary ILD care, particularly collaboration with rheumatologists, can improve early diagnosis and treatment.

Peter Forsberg, MD, discusses why health systems must adapt to expand equitable access to CAR T-cell and bispecific therapies.