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Insurer Battles Physician Group

03/06/2012

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September 2024

Volume 21

Issue 3

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Silver Loading: Impact on 2019 Premiums

05/18/2018

Mary Beth Nierengarten ;

Repealing the cost-sharing subsidies for insurers has led to the practice of “silver-loading,” in which payers increase the prices of silver plans to maximize federal subsidies.

Repealing the...

05/18/2018

First Report Managed Care

News

Medicaid Prescription Drug Rule Saves $17.7 Billion, U.S. Says

01/30/2012

First Report Managed Care

News

U.S. Proposes Bundling Some Medicare Knee, Hip Replacement Payments

07/10/2015

The U.S. agency that runs federally funded health insurance programs proposed restructuring payments for hip and knee replacement surgeries.

The U.S. agency that runs...

07/10/2015

First Report Managed Care

Commentary

Beyond Medical Cost Savings: Optimizing Payment Integrity Value

10/31/2024

Health plan leaders increasingly recognize the value of utilizing technology as a counteroffensive against high medical loss ratios, which are now close to 90% in the large group market. As the industry is poised to face the same pressures in...

Health plan leaders increasingly...

10/31/2024

First Report Managed Care

Conference Insider

Value Assessment Framework Effects on Payer Coverage Decisions

11/06/2019

As value assessment frameworks become more prominent in health care, researchers conducted a survey to see how these tools are impacting payer coverage decisions.

As value assessment frameworks...

11/06/2019

First Report Managed Care

Video Insights

Videos

Bridging the Gaps in Prior Authorization: Challenges, Solutions, and Collaboration for Better Patient Care

11/13/2024

David Sand, MD, MBA, chief medical officer at ZeOmega, discusses the challenges of prior authorization, emphasizing the need for transparency, evidence-based standards, collaboration between payers and providers, and the potential for...

David Sand, MD, MBA, chief...

11/13/2024

First Report Managed Care

Videos

The Evolving Role of CGRP-targeting Therapies in Migraine Prevention

10/31/2024

Richard Lipton, MD, provides insights on the American Headache Society’s position statement update on calcitonin gene-related peptide (CGRP)-targeting therapies as a first-line option for the prevention of migraine.

Richard Lipton, MD, provides...

10/31/2024

First Report Managed Care

Videos

Unmet Needs in the Treatment and Management of Non–Small Cell Lung Cancer

09/26/2024

Alexander Spira , MD, PhD;

Alexander I. Spira, MD, PhD, discusses significant unmet needs in the treatment and management of non–small cell lung cancer (NSCLC).

Alexander I. Spira, MD, PhD,...

09/26/2024

First Report Managed Care

Videos

Treatment Options for NSCLC: A Discussion on Coverage, Clinical Outcomes, and Payer Perspectives

09/25/2024

Learn about research developments in 1L therapy for NSCLC patients with EGFR mutations and how outcomes may impact coverage and reimbursement decisions for insurers.

Learn about research...

09/25/2024

First Report Managed Care

Videos

Addressing the Root Cause of a Common Ocular Condition: A Virtual Roundtable

09/04/2024

View a roundtable discussion on Demodex blepharitis, a prevalent ocular condition that often goes undiagnosed in patients.

View a roundtable discussion on...

09/04/2024

First Report Managed Care

Videos

Addressing Health Disparities and Promoting Equity: The Role of Advanced Imaging Solutions

08/15/2024

Guest expert Jordan Bazinsky discusses the challenges facing the medical imaging industry, the potential of AI and emerging technologies, the role of advanced imaging solutions in promoting health equity, and the key trends and challenges...

Guest expert Jordan Bazinsky...

08/15/2024

First Report Managed Care

Videos

Promising Therapies and Clinical Trials for Chronic Lymphocytic Leukemia

08/14/2024

Farrukh T. Awan , MD;

Farrukh Awan, MD, highlights promising therapies and clinical trials within the field of chronic lymphocytic leukemia (CLL).

Farrukh Awan, MD, highlights...

08/14/2024

Journal of Clinical Pathways

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...

07/31/2024

First Report Managed Care

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...

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.

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