Health care coverage, from private insurance to employer-provided health care to public programs like Medicare and Medicaid, can have various impacts on people’s use of health care and, ultimately, their health and well-being.
Americans pay more than three times what other wealthy countries pay for the same brand-name drugs. Federal policymakers have pursued most-favored-nation pricing as one answer. What it has built so far is 26 confidential deals, a Medicare model covering about four companies, and savings projections no one outside government can verify. AcademyHealth breaks down what the evidence shows, where it runs out, and what to watch.
AcademyHealth's signature storytelling series, The Evidence Effect, now has a complete pilot series. These four stories showcase the real-world impact of health services research. The series will continue highlighting HSR success stories and how evidence can improve care, inform decisions, and strengthen communities.
A Yale preprint projects $1 trillion in annual savings and 114,000 deaths prevented. A competing analysis finds a $47 trillion federal cost. Both numbers are defensible. Neither answers the same question. AcademyHealth breaks down what the evidence actually shows, where it runs out, and how to read the claims you will encounter.
School Medicaid stands at a crossroad. At a time when students’ health care needs are growing, school Medicaid plays a critical role in supporting student health and learning. Yet, H.R.1 jeopardizes this sustainable funding source for schools across the country, raising concerns about the future of school health services and students’ well-being.
School Medicaid is a lifeline for millions of students who depend on school health services to learn and thrive. Over the years, school Medicaid has expanded to reach more children. Yet despite this growth, school Medicaid programs continue to face persistent challenges including administrative burdens and funding uncertainties.
America’s children are getting sicker, with chronic and mental health conditions on the rise, trends worsened by the pandemic and felt most by underserved communities. Schools have become critical hubs for care, supported in part by Medicaid. In this three-part series, we’ll explore school Medicaid’s role and what’s at stake as policy changes, including H.R.1, threaten its future.
Medicare Advantage insurers made nearly 53 million prior authorization decisions in 2024, roughly 145,000 every day. Now, federal rules, bipartisan legislation, state laws, and a voluntary insurer pledge are all moving to reform the process. But while the reforms focus on how prior authorization works, the bigger question gets less attention: does it work?
HHS released a massive publicly available Medicaid provider-level dataset spanning six years of data (2018-2024) that features over $800 billion in claims as the Trump Administration pushes for transparency in its crusade against fraud.
For the first time at this scale, Medicaid coverage for many adults will be tied to documenting work or other qualifying activities. AcademyHealth examines what the evidence shows about coverage loss, employment effects, administrative burden, and the tradeoffs policymakers face as states prepare to implement the new requirement.
In an unprecedented move raising urgent concerns about the future of preventive care in the United States, the leadership of the U.S. Preventive Services Task Force has been removed, threatening the independent, evidence-based process that ensures millions of Americans can access life-saving screenings and services at no cost.