Cost of Care
Expert articles and analysis related to cost of care.
AI Summary — Last 30 Days
CMS is leaning harder into mandatory and quasi-mandatory cost-containment models under the Trump administration, with CMMI’s finalized GLOBE drug payment model aiming to import most-favored-nation-style Part B drug pricing while joint-replacement evidence from CJR shows episode-based bundles can cut Medicare spending without obvious quality deterioration—fueling the case for broader specialty and procedural bundles. At the same time, the cost-of-care battleground is widening beyond hospitals and physicians: states are moving into large-scale Medicaid/Medicare-aligned models such as GENEROUS, pharmacy stakeholders are testing value-based reimbursement tied to quality rather than dispensing volume, and MA plans face renewed pressure as MedPAC defends a $76B overpayment estimate even as high-rated contracts position for bonus-driven rebate advantages. For ACOs, health systems, and payers, the strategic signal is clear: downside-risk readiness, specialty-cost management, drug-spend governance, and MA coding/payment scrutiny are becoming central to VBC economics, not peripheral policy issues (CJR savings analysis; GLOBE drug pricing model).
Related Articles
Trump’s $500 ACA Refunds: ‘We Shouldn’t Confuse a Check With a Healthcare Affordability Strategy’
Trump’s $500 ACA refunds offer immediate financial relief to some enrollees, but healthcare experts question whether they address the broader affordability challenges facing Americans. The post Trump’...
New Data: Hospital Monopolies Leading to Higher Healthcare Costs
New Data: Hospital Monopolies Leading to Higher Healthcare Costs AHIP
Survey: Adults With Multiple or Complex Health Conditions Face Significant Challenges with Health Costs and Commonly Struggle to Access Care
Adults with multiple or complex health conditions, who already face unique physical and mental challenges, commonly struggle to pay their medical bills and access needed care and medication—challenges...
Health Care Access and Affordability for Adults with Multiple or Complex Health Conditions: A Snapshot of Patient Experiences
Significant shares of adults with multiple or complex health conditions, including cancer, lung disease, diabetes, cardiovascular disease, and mental health conditions say they struggle to pay their m...
Why HaloMD became a target — and what its top lobbyist says critics get wrong
Patrick Velliky is confident the No Surprises Act is lowering out-of-network spending, despite research to the contrary. HaloMD’s chief external affairs officer responds to criticisms of his analysis,...
Ban on facility fees pushed in Iowa after hospital acquisition spikes patient bills
Ban on facility fees pushed in Iowa after hospital acquisition spikes patient bills Becker's ASC
<a href="https://www.commonwealthfund.org/publications/surveys/2026/sep/how-medical-bills-debt-impact-americans-private-insurance" hreflang="en">How Medical Bills and Debt Impact Americans with Private Insurance</a>
Americans with private insurance are often frustrated in attempts to get and pay for care through their health plan, leaving them with bills they didn’t expect.
Employer healthcare costs projected to rise 9.5% in 2027
Employer healthcare costs projected to rise 9.5% in 2027 Healthcare Finance News
New Paragon Analysis Underscores Costly Provider-Led Abuse of No Surprises Act
New Paragon Analysis Underscores Costly Provider-Led Abuse of No Surprises Act AHIP