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Blog
Behind the Bill: August 7, 2024
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
Behind the Bill: July 31, 2024
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
Medicare Prescription Payment Plan: What Health Plans Need to Know
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
HIV Cases Rise Among Gay Latinos
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
Behind the Bill: July 24, 2024
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
Why We’re Already Thinking Ahead to 2028 Part B Drug Price Negotiations
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
Behind the Bill: July 17, 2024
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
Timeline of Key IRA Milestones
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
The Clash Over Medicare: Key Lawsuits Challenging the IRA’s Drug Negotiation Provisions
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
Behind the Bill: July 10, 2024
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
An IRA Progress Report: What We Know (and Don’t Know) Two Years in
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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First Reports

Weekly Dose of Hemophilia Factor VIII Therapy Delivers Significant Bleed Protection
Pegloticase Benefit Enhanced When Combined With Methotrexate for Patients With Chronic Gout
HCRU Burden of Chronic vs Episodic Migraine and Effect of Early vs Late Nonoral Triptan Use
Zanubrutinib Exhibits Superior Overall Response Rate for Adult Patients With Chronic Lymphocytic Leukemia
Access to Acute Treatments for Migraine Can Reduce Costs for Employers, Health Care System
Addition of Daratumumab to a Treatment Plan for Transplant Ineligible Patients With Multiple Myeloma Proves Beneficial
Atezolizumab Demonstrates Positive Disease-free Survival Benefit Among Patients With NSCLC
Data Supports Progression-Free Survival, Overall Survival for Long-Term CLL/SLL Treatment
ICER Report Ranks Value, Clinical Effectiveness of Dupilumab and Other AD Treatments
Dupilumab Reduces Type 2 Inflammation, May Offer Clinical Benefits for Multiple Comorbid Diseases

Commentary

Commentary
Payer-Provider Synergy: Aligning at the Fulcrum Points
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
Easing the Nursing Shortage Burden With Wins on Quality, Cost, Scale
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
Expanding Access to Life-Saving Cardiac Care
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
Making Contract Management Work in a Value-Based Care Environment
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
Creating a Better Patient Experience Through Improved Identity Data Management
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
Leveraging AI to Enhance the Member Experience for Health Plans
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
Long-Term, High-Impact Nursing Care Solutions Promote High-Value Care
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
Harnessing Innovation to Improve Maternal Health
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
Adapting to Change: Navigating the New CMS Prior Authorization Guidelines in Health Care
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
How Lab Values Can Close the Gap Between Patients With Undiagnosed and Under-Staged Chronic Kidney Disease
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
The Impact of Labor Shortages on Long-Term Care and Homecare
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
Strategies for Managing Duplicate Discounts Under the 340B Drug Discount Program
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
Insights on the 2024 Medicare Physician Fee Schedule: Implications and Opportunities for Virtual Care Management Services
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
Breaking Down Barriers: Understanding the Impact of Social Determinants of Health (Part 2)
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
Breaking Down Barriers: Understanding the Impact of Social Determinants of Health (Part 1)
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
Navigating the Future of Virtual Chronic Care Management
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
Enhancing Patient Services: Payer and Provider Considerations
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
Transforming Pharmacy Care and Drug Payment Models: Expert Insights From Asembia 2024
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
Key Pharmaceutical Pipeline Developments: Insights from Industry Experts
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
The Evolving Landscape of Specialty Pharmacy: PROs and PROMs Insights
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
Understanding the Impact of Formulary Exclusions on Medication Adherence
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
Standardizing the Field of Digital Medicine: Insights from an Industry Expert
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
Expanding Diabetes Care
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
Expert Insights into Value-Based Care for Polymyalgia Rheumatica
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
How Does CDI Impact Health Care Utilization, Costs in Older Patients?
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
CMS Unveils New AHEAD Model Aimed at State Populations
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
Navigating the Inflation Reduction Act's Impact on Drug Pricing and Health Care
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
Prioritizing Patient Voices in Drug Development and Coverage
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®
New Therapies in Development for Idiopathic Pulmonary Fibrosis (IPF) Address Existing Challenges With Diagnosis and Management
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
2024 Drugs to Watch: What Payers Should Know
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
Surgical Therapies for Vitiligo
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
A Payer Expert Analyzes Rare Disease Drug Policy
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
Predictions for US Health Care Information Technology in 2021
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
Five Trends Driving Adoption of Holistic Strategies: Focusing on Revenue Integrity
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
Three Steps to Identify and Address Social Determinants of Health
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
The Efficacy and Safety of an Oral Phosphodiesterase 4B (PDE4B) Inhibitor, BI 1015550, in Patients With Idiopathic Pulmonary Fibrosis (IPF): A Phase 2 Clinical Trial
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
A Better Way to Pay for Primary Care
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
How Whole-Person Virtual Care Closes Care Gaps and Improves Star Ratings
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
Federal Oversight of Managed Care a Priority
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
Medical Cost Increases Projected for 2024
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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FRMC Volume 21, Issue 2

Current Issue

June 2024
Volume 21
Issue 2
Current Issue
Issue Archive

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What's Trending?

News
CMS Planning MACRA Overhaul to Decrease Administrative Burden
03/21/2018
According to a recent report from the Healthcare Financial Management Association, the CMS is planning to significantly overhaul MACRA in order to decrease the administrative quality measure reporting burden.
According to a recent report from the Healthcare Financial Management Association, the CMS is planning to significantly overhaul MACRA in order to decrease the administrative quality measure reporting burden.
According to a recent report...
03/21/2018
First Report Managed Care
News
Key cuts to healthcare waste saves $3.6 trillion
06/15/2010
06/15/2010
First Report Managed Care
Who Is Responsible for Financial Toxicity in Oncology Patients?
07/13/2015

Lisa A. Tomaszewski, PhD

Lisa A. Tomaszewski, PhD
Breakthroughs in oncology often come with a hefty price tag. The moment the diagnosis of cancer is given, patients understandably rush to accept any treatment option, regardless of cost.
Breakthroughs in oncology often come with a hefty price tag. The moment the diagnosis of cancer is given, patients understandably rush to accept any treatment option, regardless of cost.
Breakthroughs in oncology often...
07/13/2015
First Report Managed Care
News
More than 50 million Americans now without health insurance
08/24/2011
08/24/2011
First Report Managed Care
News
FDA Approves Lanreotide for Neuroendocrine Tumors
12/17/2014
The FDA approved lanreotide for the treatment unresectable, differentiated, locally advanced or metastatic gastroenteropancreatic neuroendocrine tumors.
The FDA approved lanreotide for the treatment unresectable, differentiated, locally advanced or metastatic gastroenteropancreatic neuroendocrine tumors.
The FDA approved lanreotide for...
12/17/2014
First Report Managed Care

Video Insights

Hayward
Videos
Evolving Health Care Contact Centers Into Drivers of Value-Based Care
07/31/2024
Discover how health care contact centers can transform into drivers of value-based care through AI, automation, upskilling agents, and rethinking workflows and metrics to improve patient outcomes and population health.
Discover how health care contact centers can transform into drivers of value-based care through AI, automation, upskilling agents, and rethinking workflows and metrics to improve patient outcomes and population health.
Discover how health care contact...
07/31/2024
First Report Managed Care
Lucille Accetta Headshot
Videos
Enhancing Patient Medication Adherence: Insights and Strategies From Asembia 2024
06/11/2024
Lucille Accetta, PharmD, MBA, MSPH, Senior Vice President of CVS Specialty Operations
Key stakeholders in the health care industry gathered to discuss prevalent topics at this year's Asembia annual summit. Medication adherence emerged as one of the most talked-about issues. In a session led by Lucille Accetta, PharmD, MBA,...
Key stakeholders in the health care industry gathered to discuss prevalent topics at this year's Asembia annual summit. Medication adherence emerged as one of the most talked-about issues. In a session led by Lucille Accetta, PharmD, MBA,...
Key stakeholders in the health...
06/11/2024
First Report Managed Care
Melissa Andel, Principal, CommonHealth Solutions, LLC
Videos
Navigating the Impact of the Inflation Reduction Act: Implications for Payers, Patients, and Manufacturers
05/24/2024
Melissa Andel, Principal, CommonHealth Solutions, LLC
Learn about the impacts of the Inflation Reduction Act on payers and patients, highlighting the changes in Medicare benefits and drug coverage coming in 2025 and 2026.
Learn about the impacts of the Inflation Reduction Act on payers and patients, highlighting the changes in Medicare benefits and drug coverage coming in 2025 and 2026.
Learn about the impacts of the...
05/24/2024
First Report Managed Care
Joe DePinto Headshot
Videos
Navigating Payment Models in the CGT Landscape: Insights and Innovations
05/21/2024
Joe DePinto, Head of Cell, Gene, and Advanced Therapies, McKesson
An expert discusses the evolution and challenges of payment models in the cell and gene therapy (CGT) space reviewed during his session at Asembia 2024.
An expert discusses the evolution and challenges of payment models in the cell and gene therapy (CGT) space reviewed during his session at Asembia 2024.
An expert discusses the...
05/21/2024
First Report Managed Care
Jennifer L. Mathieu Senior Vice President, Professional and Government Affairs at AMCP
Videos
Unlocking the Future of Managed Care Pharmacy: A Deep Dive into Federal Legislation and Regulations
05/15/2024
Jennifer L. Mathieu Senior Vice President, Professional and Government Affairs, AMCP
Learn about developments in federal legislation and regulations within the pharmacy landscape shaping the future of managed care in an interview with a session presenter from AMCP 2024.
Learn about developments in federal legislation and regulations within the pharmacy landscape shaping the future of managed care in an interview with a session presenter from AMCP 2024.
Learn about developments in...
05/15/2024
First Report Managed Care
Tejaswi Kompala
Videos
Personalizing Weight Loss Management With GLP-1 Agonists
04/05/2024

Featuring Tejaswi Kompala, MD, head of cardiometabolic clinical strategy, Teladoc 

Featuring Tejaswi Kompala, MD, head o...
Delve into the rising demand for anti-obesity medications, the complexities of obesity management, and the importance of personalized approaches in improving cardiometabolic health in this insightful interview.
Delve into the rising demand for anti-obesity medications, the complexities of obesity management, and the importance of personalized approaches in improving cardiometabolic health in this insightful interview.
Delve into the rising demand for...
04/05/2024
First Report Managed Care
Zaubler Headshot
Videos
Integrating Behavioral Health Services to Reduce ED Visits: Substance Use Disorder and Social Determinants of Health
03/27/2024

Featuring Tom Zaubler, MD, MPH, CMO at NeuroFlow

Featuring Tom Zaubler, MD, MPH, CMO a...
Join us for the continuation of an engaging two-part series showcasing an expert dedicated to reducing emergency department visits through the integration of behavioral health practices. Dr Zaubler will share invaluable insights into...
Join us for the continuation of an engaging two-part series showcasing an expert dedicated to reducing emergency department visits through the integration of behavioral health practices. Dr Zaubler will share invaluable insights into...
Join us for the continuation of...
03/27/2024
First Report Managed Care
Zaubler Headshot
Videos
Integrating Behavioral Health Services to Reduce ED Visits: Suicide Prevention and Preemptive Primary Care
03/25/2024

Featuring Tom Zaubler, MD, MPH, CMO at NeuroFlow

Featuring Tom Zaubler, MD, MPH, CMO a...
Come join us for the first installment of a captivating two-part series featuring an expert committed to minimizing emergency department visits through the implementation of behavioral health integrations. Dr Zaubler will offer valuable...
Come join us for the first installment of a captivating two-part series featuring an expert committed to minimizing emergency department visits through the implementation of behavioral health integrations. Dr Zaubler will offer valuable...
Come join us for the first...
03/25/2024
First Report Managed Care
Yash Prajapati
Videos
Navigating the Evolution of Digital Solutions in Health Care
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
Mansur Shomali
Videos
Advancements and Challenges in Diabetes Management
02/27/2024

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

Featuring Mansur Shomali, MD, chief m...
Learn about the state of digital therapeutics for disease management such as diabetes care in terms of cost, outcomes, integration, and more with Dr Mansur Shomali, CMO at Welldoc.
Learn about the state of digital therapeutics for disease management such as diabetes care in terms of cost, outcomes, integration, and more with Dr Mansur Shomali, CMO at Welldoc.
Learn about the state of digital...
02/27/2024
First Report Managed Care

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