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Specialty medications present a challenge for payers as costs for these expensive drugs consume an increasing portion of overall health care spending. In fact, specialty pharmacy spend is expected to rise from $92 billion in 2012 to $235 billion by 2018.

Offering a first glimpse of the health care needs of Americans who bought coverage through federal and state marketplaces, an analysis of the first two months of claims data shows the new enrollees are more likely to use expensive specialty drugs to treat conditions like HIV/AIDS and hepatitis C than those with job-based insurance.

Exchange enrollment numbers recently topped 7 million people this past week, which means insurance companies across the United States are already predicting a hefty increase to consumers' 2015 health plan premiums.

Routine office visits accounted for the single largest share of Medicare physician billings in 2012 even though they amounted to just one one-seventh of the $77 billion paid by the government for physician services through the nation's senior citizens healthcare program.

The American Medical Association (AMA) said it would not block the release of 880,000 physician billing records from the Medicare claims database. The government's decision to release the information is a response to the pressure they received from employers, insurers, and consumer groups for increased transparency and access to physician payment information.

The nation's largest doctors' group said Monday it won't try to block Medicare's release of billing records for 880,000 physicians, although it continues to oppose the government's recent decision to open up the massive data trove.

Supporters point to advances such as greater takeup of EHRs by doctors, though critics say federal policymakers pushed technology long before it was ready.

The duals demonstration project launched last week in five counties, according to officials from the Department of Health Care Services, which is overseeing the project.

Highlights from recent AJMC conference coverage.

Just over half of the 114 organizations to join one of two Medicare accountable care organization efforts in 2012 report no decrease in health spending below targets during their first 12 months.

Health insurers often try to influence Washington through quiet persuasion in plush offices. To fight potential government cuts for private Medicare plans, however, they've hit the streets.

Patient access to some of the nation's best-known cancer-care centers could become a flashpoint in the simmering controversy surrounding the narrow networks being constructed by some insurers and healthcare providers.

Walgreens Pharmacists Instrumental in Helping Reduce Hospital Readmissions by Nearly 50 Percent Through WellTransitions Program

Researchers at Rockefeller University have discovered that targeting the liver-X receptor to increase the expression of ApoE can prevent melanoma cells from metastasizing to the lung and the brain.

Early detection of precancerous adenomas by colonoscopy can prevent the development of cancer.

With 2015 Medicare Advantage payment rates and policy changes pending, some lawmakers and associations are urging the Centers for Medicare & Medicaid Services to stick to the cut it proposed while others are calling for rates not to drop.

The Kansas Foundation for Medical Care and six Kansas health practices are trying to chart the path to create a new kind of doctor's office, with the goal of improving care.

Heartland Regional Medical Center had more to lose than most when it gambled and joined Medicare's experiment with accountable care in 2012. For the first year at least, that risky bet paid off.

In a 64-35 vote, the Senate approved the seventeenth fix to the sustainable growth rate (SGR) payment formula.

The ASCO task force has identified 3 goals for its strategic value initiative. First is that oncologists will have the skills and tools needed to evaluate the relative value of interventions, and will use these when discussing treatment options with their patients. Second is to have information readily accessible to help patients select high-value treatment that meets their individual needs. Third is to have an algorithm that can be used by those responsible for covering the costs of cancer care to define and assess the value of treatment options.

By passing this law, EU lawmakers loosen the grip of pharmaceutical companies on how and when physicians prescribe a particular drug.

DNA repair is a prime mechanism for preventing DNA damage, mutation, and cancers. Adopting a functional approach, we examined the association with lung cancer risk of an integrated DNA repair score, measured by a panel of three enzymatic DNA repair activities in peripheral blood mononuclear cells.

As retail clinics plan to have a role in improving health outcomes, they must achieve the 3 components of the triple aim: access, quality, and cost.

The American Society of Clinical Oncology (ASCO) has launched a strategic initiative to define value in cancer care.

Two Republicans dueled over Medicaid this morning, as the Senate's foremost opponent of expansion accused another senator of taking the "easy" route in rolling out a plan that would increase coverage.

Before the next season starts, states will be working with insurance companies to craft new plans and oversee new premium rates based on this year's claims. Most states also plan to tinker with or overhaul their websites.

Researchers discovered that microscopic "bubbles" are safe and effective storage lockers for harmful isotopes that emit ionizing radiation for treating tumors. The findings can benefit patient health and advance radiation therapy used to treat cancer and other diseases.

In February, Pfizer announced encouraging results for palbociclib with statistically significant and clinically meaningful improvement in progression-free survival (PFS) for women with a certain type of advance breast cancer in a mid-stage, or phase III, study.

GlaxoSmithKline has been forced to halt a Phase III trial assessing its MAGE-A3 cancer immunotherapeutic in patients with non-small cell lung cancer (NSCLC).

A DNA methylation marker test performed on urine samples obtained from patients with non-muscle-invasive bladder cancer (NMIBC) has the ability to predict tumor recurrence with both high sensitivity and specificity.