WATCH: Medicaid Program Looks to Negotiate Rising Drug Prices

Federal data reveals Medicaid spending on prescription drugs rose 25% in 2014 and an additional 14% in 2015, marking a sharp increase. At present, Medicaid is required to cover any FDA-approved drugs, including drugs with similar purposes. Massachusetts is looking to bring the price back down by picking and choosing which drugs they are required to offer. They argue the new rule will give them missing leverage that will save money for Medicaid and patients alike. Critics argue it makes accessing drugs more difficult for low-income patients who may not have options for inexpensive alternatives. The proposal is currently being reviewed by the Centers for Medicare and Medicaid Services, which has an unpredictable record on approvals.

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ROI
ROI Case Study
December 3, 2025

Denials are no longer a slow leak in the revenue cycle—they’re a fast-moving, rule-shifting game controlled by payers, and hospitals that don’t model denial patterns in real time end up budgeting around losses they could have prevented. PayerWatch’s four-digit, client-verified ROI in 2024 shows what happens when a hospital stops reacting claim by…

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coverage
Clip 2 – Fighting for Coverage: One Patient’s Story
December 3, 2025

Health insurers love to advertise themselves as guardians of care, but the real story often begins when a patient’s life no longer fits neatly into a spreadsheet. In oncology especially, “coverage” isn’t a bureaucratic checkbox—it’s the fragile bridge between a treatment that finally works and a relapse that can undo years of grit…

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educator advocacy
Just Thinking… About How Rapid Shifts in AI and Policy Are Elevating the Need for Educator Advocacy in Texas Schools
December 3, 2025

Schools today are navigating a whirlwind of change, from new expectations in the job market to the growing influence of AI and the constant push to rethink accountability. That’s why conversations about educator advocacy matter so much right now. Texas, for example, ranks among the lowest ten states in per-pupil funding—even while boasting the seventh-strongest…

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great leaders
Why Great Leaders Hire People Unlike Themselves
December 3, 2025

Leadership today is being reshaped by a simple lesson many leaders learn the hard way: a team full of people who think the same way won’t get you very far. Research shows that teams with deeper diversity—meaning differences in perspectives, values, and cognitive frameworks—consistently outperform more uniform teams in creativity, innovation, and complex decision-making. Today,…

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