Provider Networks
Expert articles and analysis related to provider networks.
AI Summary — Last 24 Hours
Provider-network strategy is becoming more central to VBC execution as CMS’s CMMI, under the Trump administration, advances the 10-year ACCESS chronic care model with a first cohort spanning digital health, connected care, AI-native startups, ACO enablement firms, and tech-enabled plans—signaling a push toward scalable, tech-enabled chronic disease management tied to choice, competition, and taxpayer protection under CMMI’s “Make America Healthy Again” vision (ACCESS model overview). At the same time, Medicare Advantage network disruptions are intensifying access and continuity-of-care risks for retirees, while bipartisan scrutiny of MA oversight is rising—creating tension between narrower-network cost control and the provider stability needed for ACOs, plans, and health systems to deliver longitudinal population health outcomes ([MA network shakeups](https://news.google.com/rss/articles/CBMiigFBVV95cUxOWkhSX192VUJZejh5ejRaSE1OQmJfSW0tTmJDSEJCM1ZCMXduLVhxOVNEc25EcWEzR2pwMVE2cjJjdmljQVdXZHNNUlpGM1BiNmlxNmxUWDBQX3pKM3pCXzRLQU00bUItR
Related Articles
Inside CMS’s Drug Pricing Playbook: What it Means for IPAY 2028 and Subsequent Rounds
Inside CMS’s Drug Pricing Playbook: What it Means for IPAY 2028 and Subsequent Rounds  Manatt, Phelps & Phillips, LLP
often done through a proprietary algorithm
From newsletter: The LI Daily: PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs want transparency rule on ice, but drug ...
punted on finalizing a policy
From newsletter: The LI Daily: PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs want transparency rule on ice, but drug ...
group purchasing organizations
From newsletter: The LI Daily: PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs want transparency rule on ice, but drug ...
Prime Therapeutics
From newsletter: The LI Daily: PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs want transparency rule on ice, but drug ...
several new requirements on PBMs
From newsletter: The LI Daily: PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs want transparency rule on ice, but drug ...
Does biosimilar entry reduce cost for patients?
Biosimilars aim to be lower cost options for biologic therapies after loss of exclusivity. A key question is whether these cost savings get passed through to patients via lower out-of-pocket costs. A ...
specifically asked
From newsletter: The LI Daily: PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs warn Trump’s proposal to disclose drug prices is illegal PBMs want transparency rule on ice, but drug ...
3. Chief Pharmacy Officers are being asked to lead across operations, finance, clinical ...
3. Chief Pharmacy Officers are being asked to lead across operations, finance, clinical ... - Becker's Hospital Review  Becker's Hospital Review
STAT+: French regulator fines Novo and Lilly over weight loss ad campaigns
France's medicines regulator has fined Novo Nordisk and Eli Lilly over their weight loss ad campaigns.