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April 2015 - FRMC

Coordinating Managed Care and Long-Term Services and Support
06/18/2015
In the United States, two-thirds of nursing home residents’ costs are funded by Medicaid.
In the United States, two-thirds of nursing home residents’ costs are funded by Medicaid.
In the United States, two-thirds...
06/18/2015
First Report Managed Care
An Analysis of Prescription Drug Use by Exchange Enrollees in the First Year of Coverage
06/18/2015
According to a report from Prime Therapeutics, customers who purchased health insurance on the exchange via the Patient Protection and Affordable Care Act filled 13.6% more prescriptions on average compared with commercial members.
According to a report from Prime Therapeutics, customers who purchased health insurance on the exchange via the Patient Protection and Affordable Care Act filled 13.6% more prescriptions on average compared with commercial members.
According to a report from Prime...
06/18/2015
First Report Managed Care
Targeted Biopsy Identifies Prostate Cancer Better than Standard Biopsy
06/18/2015
A study of men undergoing biopsy for suspected prostate cancer used targeted MRI/ultrasound fusion biopsy to detect cancers.    
A study of men undergoing biopsy for suspected prostate cancer used targeted MRI/ultrasound fusion biopsy to detect cancers.    
A study of men undergoing biopsy...
06/18/2015
First Report Managed Care

Department

Conference Insider
Improving Care Coordination in Medicaid Managed Care
06/18/2015
An increasing number of aging adults and disabled individuals are enrolling in Medicaid due to the recent decision by many states to expand Medicaid coverage.
An increasing number of aging adults and disabled individuals are enrolling in Medicaid due to the recent decision by many states to expand Medicaid coverage.
An increasing number of...
06/18/2015
First Report Managed Care
Conference Insider
Integrating Managed Care and Medicaid
06/18/2015
In 2013, state and local Medicaid spending increased 5.9% and federal Medicaid spending increased 6.2%, with a total increase of 6.1% in Medicaid expenditures.
In 2013, state and local Medicaid spending increased 5.9% and federal Medicaid spending increased 6.2%, with a total increase of 6.1% in Medicaid expenditures.
In 2013, state and local...
06/18/2015
First Report Managed Care

News

News
Effect of Medicare Part D and Generics on Breast Cancer Treatment
06/18/2015
In the United States, breast cancer is the second most common cancer diagnosis and the second most fatal form of cancer among women. Endocrine therapy agents, including aromatase inhibitors (AIs) and tamoxi- fen, have shown effectiveness in...
In the United States, breast cancer is the second most common cancer diagnosis and the second most fatal form of cancer among women. Endocrine therapy agents, including aromatase inhibitors (AIs) and tamoxi- fen, have shown effectiveness in...
In the United States, breast...
06/18/2015
First Report Managed Care
News
11 Million Americans Gain Insurance Since Passage of ACA
06/18/2015
Since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law 5 years ago, the number of insured Americans has dropped by more than 11 million to the lowest level in 15 years, according to new...
Since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law 5 years ago, the number of insured Americans has dropped by more than 11 million to the lowest level in 15 years, according to new...
Since President Barack Obama...
06/18/2015
First Report Managed Care
News
Examining Treatment Costs Related to HIV-Positive Dually Enrolled Medicare Beneficiaries
06/18/2015
In the United States, Medicare and Medicaid account for more than three-quarters of domestic federal spending on HIV/AIDS treatment. In turn, policymakers are interested in monitoring the cost and quality of treatments for HIV/AIDS. 
In the United States, Medicare and Medicaid account for more than three-quarters of domestic federal spending on HIV/AIDS treatment. In turn, policymakers are interested in monitoring the cost and quality of treatments for HIV/AIDS. 
In the United States, Medicare...
06/18/2015
First Report Managed Care
News
Long-Term Mortality Higher in Patients with Diabetes and COPD
06/18/2015
Patients with a confirmed physician's diagnosis of diabetes had a higher risk of long-term mortality after a mild to moderate exacerbation of chronic obstructive pulmonary disease (COPD), according to the results of a recent study.
Patients with a confirmed physician's diagnosis of diabetes had a higher risk of long-term mortality after a mild to moderate exacerbation of chronic obstructive pulmonary disease (COPD), according to the results of a recent study.
Patients with a confirmed...
06/18/2015
First Report Managed Care
News
5 Years After ACA Enacted: Poll Examines Opinion on the Law
06/18/2015
March marked 5 years since the Patient Protection and Affordable Care Act (ACA) was passed into law. With the Supreme Court set to weigh in on the law in the case of King v. Burwell, the Kaiser Family Foundation presented results of a poll...
March marked 5 years since the Patient Protection and Affordable Care Act (ACA) was passed into law. With the Supreme Court set to weigh in on the law in the case of King v. Burwell, the Kaiser Family Foundation presented results of a poll...
March marked 5 years since the...
06/18/2015
First Report Managed Care
FRMC Volume 21, Issue 3

Current Issue

September 2024
Volume 21
Issue 3
Current Issue
Issue Archive

What's Trending?

News
Call for Gastric Surgery to be Standard Diabetes Treatment
05/25/2016
People with diabetes should be offered gastric surgery as a standard treatment option which could help control it for years without medication.
People with diabetes should be offered gastric surgery as a standard treatment option which could help control it for years without medication.
People with diabetes should be...
05/25/2016
First Report Managed Care
News
Montana Lawmakers Propose New Abortion Regulations for Medicaid Reimbursement
01/24/2023
Under the proposed change, providers would be required to have state approval before performing an abortion and submit supporting documents to demonstrate the procedure's medical necessity.
Under the proposed change, providers would be required to have state approval before performing an abortion and submit supporting documents to demonstrate the procedure's medical necessity.
Under the proposed change,...
01/24/2023
First Report Managed Care
Trends in Coronary Revascularization Procedures
08/22/2011
One of the most common major medical procedures provided by the healthcare system in the United States, coronary revascularization, is performed >1 million times each year. The procedure comprises coronary artery bypass graft (CABG)...
One of the most common major medical procedures provided by the healthcare system in the United States, coronary revascularization, is performed >1 million times each year. The procedure comprises coronary artery bypass graft (CABG)...
One of the most common major...
08/22/2011
First Report Managed Care
News
Insurer wants focus on what drives up health costs
03/28/2011
03/28/2011
First Report Managed Care
News
Takeda’s Successor Drug to Actos Fails to Win Approval
04/26/2012
04/26/2012
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 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
Richard Lipton, MD
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 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
Alexander Spira, MD, PhD
Videos
Unmet Needs in the Treatment and Management of Non–Small Cell Lung Cancer
09/26/2024
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, 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 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
Title Card
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 Demodex blepharitis, a prevalent ocular condition that often goes undiagnosed in patients.
View a roundtable discussion on...
09/04/2024
First Report Managed Care
Jordan Bazinsky
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 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
Farrukh Awan, MD
Videos
Promising Therapies and Clinical Trials for Chronic Lymphocytic Leukemia
08/14/2024
Farrukh Awan, MD, highlights promising therapies and clinical trials within the field of chronic lymphocytic leukemia (CLL).
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
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

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