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Blog
08/07/2024
Supreme Court overturns Chevron: what it means for FDA power, drug laws, and public health.
Supreme Court overturns Chevron: what it means for FDA power, drug laws, and public health.
Supreme Court overturns Chevron:...
08/07/2024
First Report Managed Care
Blog
07/31/2024
With 300 active drug shortages, several industry stakeholders have proposed plans to enhance supply chain resilience.
With 300 active drug shortages, several industry stakeholders have proposed plans to enhance supply chain resilience.
With 300 active drug shortages,...
07/31/2024
First Report Managed Care
Blog
07/29/2024
The Centers for Medicare and Medicaid Services recently released final part two guidance on the Medicare Prescription Payment Plan (M3P), formerly known as "smoothing."
The Centers for Medicare and Medicaid Services recently released final part two guidance on the Medicare Prescription Payment Plan (M3P), formerly known as "smoothing."
The Centers for Medicare and...
07/29/2024
First Report Managed Care
News
07/24/2024
As HIV rates continue to rise among Latino gay and bisexual men, health policy advocates stress the need for more federal assistance for HIV treatment and prevention in this community.
As HIV rates continue to rise among Latino gay and bisexual men, health policy advocates stress the need for more federal assistance for HIV treatment and prevention in this community.
As HIV rates continue to rise...
07/24/2024
First Report Managed Care
Blog
07/24/2024
The M3P offers financial relief by spreading payment throughout the year, and CMS’ latest guidance clarifies key outreach parameters.
The M3P offers financial relief by spreading payment throughout the year, and CMS’ latest guidance clarifies key outreach parameters.
The M3P offers financial relief...
07/24/2024
First Report Managed Care
Blog
07/18/2024
Learn why industry stakeholders should prepare for 2028 negotiations now to ensure long-term financial stability and regulatory compliance.
Learn why industry stakeholders should prepare for 2028 negotiations now to ensure long-term financial stability and regulatory compliance.
Learn why industry stakeholders...
07/18/2024
First Report Managed Care
FY2025
Blog
07/17/2024
FY 2025 planning shows potential budget cuts for HHS and FDA, which could limit their ability to enforce regulations and address key issues.
FY 2025 planning shows potential budget cuts for HHS and FDA, which could limit their ability to enforce regulations and address key issues.
FY 2025 planning shows potential...
07/17/2024
First Report Managed Care
Infographic thumbnail
07/15/2024
As we approach the 2-year anniversary of the enactment of the Inflation Reduction Act, let's take a look at key upcoming milestones.
As we approach the 2-year anniversary of the enactment of the Inflation Reduction Act, let's take a look at key upcoming milestones.
As we approach the 2-year...
07/15/2024
First Report Managed Care
Blog
07/11/2024
The IRA has spawned a series of lawsuits from pharmaceutical companies. Here, we provide the latest status updates on several of them.
The IRA has spawned a series of lawsuits from pharmaceutical companies. Here, we provide the latest status updates on several of them.
The IRA has spawned a series of...
07/11/2024
First Report Managed Care
Blog
07/10/2024
In the first installment of Behind the Bill, we look at the potential industry effects of the Chevron doctrine overturn and the Corner Post ruling.
In the first installment of Behind the Bill, we look at the potential industry effects of the Chevron doctrine overturn and the Corner Post ruling.
In the first installment of...
07/10/2024
First Report Managed Care
Blog
07/09/2024
In this blog the HMP Market Access Intelligence team breaks down the knowns and unknowns of the Inflation Reduction Act's impact on drug price negotiations and what the future may hold.
In this blog the HMP Market Access Intelligence team breaks down the knowns and unknowns of the Inflation Reduction Act's impact on drug price negotiations and what the future may hold.
In this blog the HMP Market...
07/09/2024
First Report Managed Care

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Commentary

Commentary
08/05/2024
Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...
Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...
Payer-provider collaboration...
08/05/2024
First Report Managed Care
Commentary
07/10/2024
Already challenged with cost, care, and administrative pressures, health care organizations are now staring down a daunting talent supply-and-demand gap. This shortage will negatively affect affordability and access to care for consumers and...
Already challenged with cost, care, and administrative pressures, health care organizations are now staring down a daunting talent supply-and-demand gap. This shortage will negatively affect affordability and access to care for consumers and...
Already challenged with cost,...
07/10/2024
First Report Managed Care
Darland Headshot
Commentary
07/01/2024
More than 6 million Americans are living with heart failure (HF), the leading cause of hospitalization among adults 65 and older. In this commentary, Chris Darland, CEO, Peerbridge Health, discusses emerging technologies, such as AI-enabled...
More than 6 million Americans are living with heart failure (HF), the leading cause of hospitalization among adults 65 and older. In this commentary, Chris Darland, CEO, Peerbridge Health, discusses emerging technologies, such as AI-enabled...
More than 6 million Americans...
07/01/2024
First Report Managed Care
Commentary
06/12/2024
Lynn Carroll, Chief Operating Officer, HSBlox
David Wolf, Vice President of Product Management, MedeAnalytics
Value-based care (VBC) models aim improve clinical outcomes and reduce health care costs by proactively focusing on patient wellness. To make this preventive approach to individual and population care work, patients, providers, payers, and...
Value-based care (VBC) models aim improve clinical outcomes and reduce health care costs by proactively focusing on patient wellness. To make this preventive approach to individual and population care work, patients, providers, payers, and...
Value-based care (VBC) models...
06/12/2024
First Report Managed Care
Clay Ritchey Headshot
Commentary
06/04/2024
Clay Ritchey, CEO, Verato
The ever evolving and pervasive digital ecosystem has transformed the way consumers research, engage, and transact—with more transparency and efficiency than ever before. And as health care digital transformation continues, consumers are...
The ever evolving and pervasive digital ecosystem has transformed the way consumers research, engage, and transact—with more transparency and efficiency than ever before. And as health care digital transformation continues, consumers are...
The ever evolving and pervasive...
06/04/2024
First Report Managed Care
Commentary
05/28/2024
Tim Price, Chief Product Officer at Infermedica
The role of artificial intelligence (AI) is becoming increasingly significant, particularly in enhancing the customer experience for health plan members. Health plan executives have a unique opportunity to leverage AI’s potential, mirroring...
The role of artificial intelligence (AI) is becoming increasingly significant, particularly in enhancing the customer experience for health plan members. Health plan executives have a unique opportunity to leverage AI’s potential, mirroring...
The role of artificial...
05/28/2024
First Report Managed Care
Anne Headshot
Commentary
05/06/2024
Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN
It's no secret that nursing is in a state of crisis. From the onset of the COVID-19 pandemic to now, nurses nationwide have increasingly battled rising burnout and stress–all while caring for higher-acuity patients, with less support. Anne...
It's no secret that nursing is in a state of crisis. From the onset of the COVID-19 pandemic to now, nurses nationwide have increasingly battled rising burnout and stress–all while caring for higher-acuity patients, with less support. Anne...
It's no secret that nursing is...
05/06/2024
First Report Managed Care
Headshots
Commentary
04/09/2024

Britteny Matero, partner and senior vice president, Market Access, Innsena, and Jaime Bland, DNP, RN, president and chief executive officer, CyncHealth

Britteny Matero, partner and senior v...
The US faces a critical maternal health crisis, with high maternal mortality rates exacerbated by COVID-19 and racial disparities. Institutional changes are needed to prevent these largely preventable deaths, and two experts highlight...
The US faces a critical maternal health crisis, with high maternal mortality rates exacerbated by COVID-19 and racial disparities. Institutional changes are needed to prevent these largely preventable deaths, and two experts highlight...
The US faces a critical maternal...
04/09/2024
First Report Managed Care
Shannon Smith Headshot
Commentary
04/02/2024

Shannon Smith, RN, BSN

Shannon Smith, RN, BSN
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry...
04/02/2024
First Report Managed Care
Julie Schulz headshot
Commentary
03/27/2024

By Julie Schulz, MD, MPH

By Julie Schulz, MD, MPH
Chronic kidney disease (CKD) is an insidious condition with devastating consequences when detected and treated too late. While primary care physicians usually make the initial diagnosis, regular screening is not routine for the general...
Chronic kidney disease (CKD) is an insidious condition with devastating consequences when detected and treated too late. While primary care physicians usually make the initial diagnosis, regular screening is not routine for the general...
Chronic kidney disease (CKD) is...
03/27/2024
First Report Managed Care

Interviews

O & S
Interview
07/31/2024
Guest experts weigh in on the ongoing issue of labor shortages in the health care homecare industry as well as solutions for maintaining a robust, engaged, and well-trained workforce.
Guest experts weigh in on the ongoing issue of labor shortages in the health care homecare industry as well as solutions for maintaining a robust, engaged, and well-trained workforce.
Guest experts weigh in on the...
07/31/2024
First Report Managed Care
Gavin Magaha
Interview
07/31/2024
Discover insights from an industry expert on 340B policy and compliance as they delve into industry trends, potential reforms, and the future of drug discount programs in the health care landscape.
Discover insights from an industry expert on 340B policy and compliance as they delve into industry trends, potential reforms, and the future of drug discount programs in the health care landscape.
Discover insights from an...
07/31/2024
First Report Managed Care
Brian Esterly Headshot
Interview
07/26/2024
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician...
07/26/2024
First Report Managed Care
Ryan Bosch
Interview
07/24/2024
Discover how social determinants of health have historically been overlooked in health care, the obstacles preventing professionals from addressing them, and the potential consequences of reducing policy support in this eye-opening interview...
Discover how social determinants of health have historically been overlooked in health care, the obstacles preventing professionals from addressing them, and the potential consequences of reducing policy support in this eye-opening interview...
Discover how social determinants...
07/24/2024
First Report Managed Care
Ryan Bosch
Interview
07/09/2024
Discover how social determinants of health have historically been overlooked in healthcare, the obstacles preventing professionals from addressing them, and the potential consequences of reducing policy support in this eye-opening interview...
Discover how social determinants of health have historically been overlooked in healthcare, the obstacles preventing professionals from addressing them, and the potential consequences of reducing policy support in this eye-opening interview...
Discover how social determinants...
07/09/2024
First Report Managed Care
Brian Esterly
Interview
06/28/2024
Learn about the impact of the 2024 Medicare Physician Fee Schedule, the importance of virtual care management services in chronic care, and how organizations like TimeDoc can help providers navigate the changing health care landscape.
Learn about the impact of the 2024 Medicare Physician Fee Schedule, the importance of virtual care management services in chronic care, and how organizations like TimeDoc can help providers navigate the changing health care landscape.
Learn about the impact of the...
06/28/2024
First Report Managed Care
Interview
06/28/2024
Patient services emerged as a central topic at AXS24, with many stakeholders emphasizing the need for consistency and accessibility in patient support. They also highlighted the importance of addressing both financial and emotional support...
Patient services emerged as a central topic at AXS24, with many stakeholders emphasizing the need for consistency and accessibility in patient support. They also highlighted the importance of addressing both financial and emotional support...
Patient services emerged as a...
06/28/2024
First Report Managed Care
Alison Lum Headshot
Interview
06/06/2024
Alison Lum, PharmD, Vice President of Pharmacy Services at Blue Shield of California
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum,...
06/06/2024
First Report Managed Care
Interview
05/29/2024
Leslie Fish, RPh, Senior Vice President of Clinical Pharmacy, IPD Analytics, LLC
Jeffrey Casberg, MS, RPh, IPD, Vice President of Clinical Pharmacy, IPD Analytics, LLC
Learn about promising drugs currently in the pharmaceutical pipeline and the impact of FDA interventions from presenters at AMCP 2024.
Learn about promising drugs currently in the pharmaceutical pipeline and the impact of FDA interventions from presenters at AMCP 2024.
Learn about promising drugs...
05/29/2024
First Report Managed Care
Carmine DeNardo Headshot
Interview
05/28/2024
Carmine Denardo, RPh, General Manager & Vice President, Specialty Pharmacy Services, Omnicell
Following Asembia 2024, an expert emphasizes the critical role of specialty pharmacies in patient care and highlights payers' increasing coverage of high-cost biologics and oncology medications, driven by value-based contracts and real-world...
Following Asembia 2024, an expert emphasizes the critical role of specialty pharmacies in patient care and highlights payers' increasing coverage of high-cost biologics and oncology medications, driven by value-based contracts and real-world...
Following Asembia 2024, an...
05/28/2024
First Report Managed Care

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Podcasts

Owens
Podcasts
03/28/2024

Featuring Gary Owens, MD, president of Gary Owens Associates

Featuring Gary Owens, MD, president o...
Join us as guest expert Gary Owens discusses how formulary exclusions can impact patient medication adherence and lead to adverse economic outcomes, making the need for non-medical switching and formulary exception requests an important issue...
Join us as guest expert Gary Owens discusses how formulary exclusions can impact patient medication adherence and lead to adverse economic outcomes, making the need for non-medical switching and formulary exception requests an important issue...
Join us as guest expert Gary...
03/28/2024
First Report Managed Care
Prajapati Podcast
Podcasts
02/27/2024

Featuring Yash Prajapati, consultant at ZS Associates 

Featuring Yash Prajapati, consultant ...
Join us in exploring the challenges and opportunities in the development, approval, and integration of digital therapeutic solutions with ZS Associates Consultant Yash Prajapati.
Join us in exploring the challenges and opportunities in the development, approval, and integration of digital therapeutic solutions with ZS Associates Consultant Yash Prajapati.
Join us in exploring the...
02/27/2024
First Report Managed Care
Shomali Podcast
Podcasts
02/27/2024

Featuring Mansur Shomali, MD, chief medical officer at Welldoc, endocrinologist at MedStar Health 

Featuring Mansur Shomali, MD, chief m...
Discover how digital therapeutics are revolutionizing disease management, patient care, reducing health care costs, and more with Dr Mansur Shomali, CMO at Welldoc.
Discover how digital therapeutics are revolutionizing disease management, patient care, reducing health care costs, and more with Dr Mansur Shomali, CMO at Welldoc.
Discover how digital...
02/27/2024
First Report Managed Care
Larry Hsu Headshot
Podcasts
01/11/2024

Featuring Larry Hsu, MD, medical director at HMSA

Featuring Larry Hsu, MD, medical dire...
A doctor and expert in value-based care offers insights into treatment costs and treatment regimens for patients with polymyalgia rheumatica.
A doctor and expert in value-based care offers insights into treatment costs and treatment regimens for patients with polymyalgia rheumatica.
A doctor and expert in...
01/11/2024
First Report Managed Care
alpesh amin
Podcasts
10/23/2023

Featuring Alpesh Amin, MD, MBA 

Featuring Alpesh Amin, MD, MBA  ...
Alpesh Amin, MD, MBA , professor and chair, University of California, discusses the results of a recent study, and explains why better treatments to reduce primary C difficile infection and recurrences in older adults can lower the mortality...
Alpesh Amin, MD, MBA , professor and chair, University of California, discusses the results of a recent study, and explains why better treatments to reduce primary C difficile infection and recurrences in older adults can lower the mortality...
Alpesh Amin, MD, MBA , professor...
10/23/2023
First Report Managed Care

Department

News Connection
05/30/2024
Paul Nicolaus
The Centers for Medicare & Medicaid Services (CMS)'s AHEAD model aims to improve population health management by awarding funding to states and promoting primary care investment and enhanced equity measures, but implementation challenges and...
The Centers for Medicare & Medicaid Services (CMS)'s AHEAD model aims to improve population health management by awarding funding to states and promoting primary care investment and enhanced equity measures, but implementation challenges and...
The Centers for Medicare &...
05/30/2024
First Report Managed Care
News Connection
05/29/2024
Dean Celia
During a recent webinar hosted by the Drug Channels Institute, Adam Fein, PhD, discussed the specifics of the Inflation Reduction Act (IRA) and its potential impacts and timeline. First Report Managed Care connected with other managed care...
During a recent webinar hosted by the Drug Channels Institute, Adam Fein, PhD, discussed the specifics of the Inflation Reduction Act (IRA) and its potential impacts and timeline. First Report Managed Care connected with other managed care...
During a recent webinar hosted...
05/29/2024
First Report Managed Care
Managed Care Q&A
05/27/2024
Jasmine Patel, Senior Principal, Patient Advocacy, Strategic Consulting at Envision Pharma Group
Jessica Krauser, Marketing Advisor, Envision Pharma Group; Founder of 5kforJK
In this interview, guest experts discuss the importance of incorporating patient voices into health care decision-making, highlighting opportunities for collaboration and enhancement in drug development and patient coverage.
In this interview, guest experts discuss the importance of incorporating patient voices into health care decision-making, highlighting opportunities for collaboration and enhancement in drug development and patient coverage.
In this interview, guest experts...
05/27/2024
First Report Managed Care
IPF letters
Formulary Frontlines®
05/13/2024

Reviewed by Elizabeth Volkmann, MD, MS

Reviewed by Elizabeth Volkmann, MD, M...
IPF is a chronic, progressive interstitial lung disease that presents a significant burden to ~3 million patients worldwide. Despite ongoing challenges with IPF diagnosis and management, new therapies in development are showing promise.
IPF is a chronic, progressive interstitial lung disease that presents a significant burden to ~3 million patients worldwide. Despite ongoing challenges with IPF diagnosis and management, new therapies in development are showing promise.
IPF is a chronic, progressive...
05/13/2024
First Report Managed Care
Managed Care Q&A
03/01/2024

Featuring John Stahl, Senior Director, Consulting at Clarivate and Matthew Arnold, Principal Analyst at Clarivate

Featuring John Stahl, Senior Director...
Experts from Clarivate discuss the evolving pharmaceutical landscape in 2024, emphasizing the need for payers to balance supporting innovative breakthrough medicines with containing health care costs.
Experts from Clarivate discuss the evolving pharmaceutical landscape in 2024, emphasizing the need for payers to balance supporting innovative breakthrough medicines with containing health care costs.
Experts from Clarivate discuss...
03/01/2024
First Report Managed Care

Columns

Surgical Pearls
10/18/2022
Riya Gandhi, MA, Associate Editor
In this interview, Loren D. Krueger, MD, met with The Dermatologist to discuss the benefits and risks of surgical treatments for patients with vitiligo based on a recent systematic review and meta-analysis.
In this interview, Loren D. Krueger, MD, met with The Dermatologist to discuss the benefits and risks of surgical treatments for patients with vitiligo based on a recent systematic review and meta-analysis.
In this interview, Loren D....
10/18/2022
The Dermatologist
Viewpoint
06/06/2022
Edmund J Pezalla, MD
Edmund J Pezalla, MD, founder and CEO of Enlightenment Bioconsult, Hartford, CT provides insight on rare disease drug policy noting volume and indication-based contracts as potential solutions for managing costs of therapies.
Edmund J Pezalla, MD, founder and CEO of Enlightenment Bioconsult, Hartford, CT provides insight on rare disease drug policy noting volume and indication-based contracts as potential solutions for managing costs of therapies.
Edmund J Pezalla, MD, founder...
06/06/2022
First Report Managed Care
Viewpoint
05/28/2021

Chris Hobson, MD, Chief Medical Officer at Orion Health

Chris Hobson, MD, Chief Medical Offic...
"COVID-19 and political uncertainty placed immense pressure across the entirety of the health care industry as organizations were tasked with balancing an already overloaded system with limited resources and shifting priorities to respond...
"COVID-19 and political uncertainty placed immense pressure across the entirety of the health care industry as organizations were tasked with balancing an already overloaded system with limited resources and shifting priorities to respond...
"COVID-19 and political...
05/28/2021
First Report Managed Care
Viewpoint
04/12/2021

Vasilios Nassiopoulos, Vice President of Platform Strategy and Innovation, Hayes

Vasilios Nassiopoulos, Vice President...
Holistic approaches to revenue integrity ensure that all billing and compliance functions are working collaboratively to address all sides of a claim.
Holistic approaches to revenue integrity ensure that all billing and compliance functions are working collaboratively to address all sides of a claim.
Holistic approaches to revenue...
04/12/2021
First Report Managed Care
Viewpoint
08/31/2020

Jessica Schiller, RN, BSN, MAS, Director of Clinical Programs at Wellframe

Jessica Schiller, RN, BSN, MAS, Direc...
Social determinants of health (SDoH) reflect a wide variety of factors, including where people live, their education level, their occupation, and their ability to access support networks.
Social determinants of health (SDoH) reflect a wide variety of factors, including where people live, their education level, their occupation, and their ability to access support networks.
Social determinants of health...
08/31/2020
First Report Managed Care

Features

Infographic
07/24/2024
This infographic summarizes a recent Phase 2 clinical trial evaluating the efficacy and safety of an oral phosphodiesterase inhibitor in patients with idiopathic pulmonary fibrosis (IPF).
This infographic summarizes a recent Phase 2 clinical trial evaluating the efficacy and safety of an oral phosphodiesterase inhibitor in patients with idiopathic pulmonary fibrosis (IPF).
This infographic summarizes a...
07/24/2024
First Report Managed Care
Feature Story
05/31/2024
Mary Beth Nierengarten
A push for a hybrid payment model for primary care is gaining momentum, with advocates urging the CMS to implement changes to increase funding and improve outcomes for patients.
A push for a hybrid payment model for primary care is gaining momentum, with advocates urging the CMS to implement changes to increase funding and improve outcomes for patients.
A push for a hybrid payment...
05/31/2024
First Report Managed Care
Cover Story
05/27/2024
Hunter Sinclair, VP of Government Markets, Teladoc Health
Discover how whole-person virtual care can revolutionize Medicare Advantage plans, improving member satisfaction, Star ratings, and financial outcomes in an increasingly competitive market.
Discover how whole-person virtual care can revolutionize Medicare Advantage plans, improving member satisfaction, Star ratings, and financial outcomes in an increasingly competitive market.
Discover how whole-person...
05/27/2024
First Report Managed Care
Cover Story
03/01/2024
Mary Beth Nierengarten
In 2022, Medicare Advantage plans covered 50% of Medicare enrollees, costing the federal government $403 billion, while 81% of Medicaid enrollees received care through managed care for $254 billion. The Health and Human Services Office of...
In 2022, Medicare Advantage plans covered 50% of Medicare enrollees, costing the federal government $403 billion, while 81% of Medicaid enrollees received care through managed care for $254 billion. The Health and Human Services Office of...
In 2022, Medicare Advantage...
03/01/2024
First Report Managed Care
Feature Story
03/01/2024
Paul Nicolaus
PwC's Health Research Institute surveyed health plan actuaries covering nearly 100 million employer-sponsored and 10 million Affordable Care Act marketplace members to project medical cost trends for 2023-2024, highlighting factors like...
PwC's Health Research Institute surveyed health plan actuaries covering nearly 100 million employer-sponsored and 10 million Affordable Care Act marketplace members to project medical cost trends for 2023-2024, highlighting factors like...
PwC's Health Research Institute...
03/01/2024
First Report Managed Care

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