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April 2015 - FRMC

Coordinating Managed Care and Long-Term Services and Support
06/18/2015
Melissa D. Cooper
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
Kerri Fitzgerald
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
Mary Mihalovic
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
Melissa D. Cooper
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
Melissa D. Cooper
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
Melissa D. Cooper
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
Jolynn Tumolo
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
Kerri Fitzgerald
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
Mary Mihalovic
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
Kerri Fitzgerald
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

Behind the Bill

Behind the Bill
SCOTUS Takes on the Nondelegation Doctrine: Surprising Reactions and What They Mean for Agency Power
04/02/2025
Katie Hayes, MJ
The Supreme Court recently heard arguments in Federal Communication Commission (FCC) v Consumers’ Research, a case that I covered in February and one that could dramatically reshape federal agency authority through the nondelegation...
The Supreme Court recently heard arguments in Federal Communication Commission (FCC) v Consumers’ Research, a case that I covered in February and one that could dramatically reshape federal agency authority through the nondelegation...
The Supreme Court recently heard...
04/02/2025
First Report Managed Care
Behind the Bill
Dr Oz’s Prescription for Making Medicaid “Viable at Every Level”
03/26/2025
Katie Hayes, MJ
On Tuesday, March 25, 2025, the Senate Finance Committee voted to advance Dr Mehmet Oz in his confirmation as the next head of the Centers for Medicare and Medicaid Services (CMS).1 The full Senate vote is expected “soon” (whatever that...
On Tuesday, March 25, 2025, the Senate Finance Committee voted to advance Dr Mehmet Oz in his confirmation as the next head of the Centers for Medicare and Medicaid Services (CMS).1 The full Senate vote is expected “soon” (whatever that...
On Tuesday, March 25, 2025, the...
03/26/2025
First Report Managed Care
Behind the Bill
The $880 Billion Question Continues: Dr Oz's Confirmation and the Future of Medicaid
03/19/2025
Katie Hayes, MJ
Last week, I explored the $880 billion question facing Congress—whether lawmakers could achieve their budget goals without cutting Medicaid. This week, that question took center stage as Dr Mehmet Oz, President Trump's nominee to lead the...
Last week, I explored the $880 billion question facing Congress—whether lawmakers could achieve their budget goals without cutting Medicaid. This week, that question took center stage as Dr Mehmet Oz, President Trump's nominee to lead the...
Last week, I explored the $880...
03/19/2025
First Report Managed Care
Behind the Bill
The $880 Billion Question: Can Congress Cut Spending Without Touching Medicaid?
03/12/2025
Katie Hayes, MJ
I’d like to step away from administrative law for a moment to provide a quick update on Medicaid. With news coming from all sides, what does the future of Medicaid actually look like? The House of Representatives narrowly passed a budget...
I’d like to step away from administrative law for a moment to provide a quick update on Medicaid. With news coming from all sides, what does the future of Medicaid actually look like? The House of Representatives narrowly passed a budget...
I’d like to step away from...
03/12/2025
First Report Managed Care
Behind the Bill
RFK Jr’s Public Comment Ban: The Silent Shift in Health Care Rulemaking
03/05/2025
Katie Hayes, MJ
The erosion of administrative law continues, and with it, the dismantling of decades-long precedent. In June, the Supreme Court overturned a 40-year-old doctrine that allowed federal agencies to interpret their own ambiguous statutes. Later...
The erosion of administrative law continues, and with it, the dismantling of decades-long precedent. In June, the Supreme Court overturned a 40-year-old doctrine that allowed federal agencies to interpret their own ambiguous statutes. Later...
The erosion of administrative...
03/05/2025
First Report Managed Care
Behind the Bill
Prevention Over Pills? The First 2 Weeks of Health Care’s New Direction
02/26/2025
Katie Hayes, MJ
The dust has barely settled from Robert F Kennedy Jr’s confirmation as Secretary of Health and Human Services (HHS), but the changes are already coming fast and furious—a key theme of the Trump Administration’s actions within the last several...
The dust has barely settled from Robert F Kennedy Jr’s confirmation as Secretary of Health and Human Services (HHS), but the changes are already coming fast and furious—a key theme of the Trump Administration’s actions within the last several...
The dust has barely settled from...
02/26/2025
First Report Managed Care
Behind the Bill
The Nondelegation Doctrine: The Next Constitutional Showdown (Part 2)
02/19/2025
Katie Hayes, MJ
Last week, I explored the potential revival of the nondelegation doctrine through Federal Communication Commission v Consumers’ Research. Today, I want to examine what this could mean for health care regulation by considering the parallels...
Last week, I explored the potential revival of the nondelegation doctrine through Federal Communication Commission v Consumers’ Research. Today, I want to examine what this could mean for health care regulation by considering the parallels...
Last week, I explored the...
02/19/2025
First Report Managed Care
Behind the Bill
The Nondelegation Doctrine: The Next Constitutional Showdown (Part 1)
02/12/2025
Katie Hayes, MJ
Just when you thought the dust had settled from the Chevron decision, the Supreme Court is gearing up to hear arguments in Federal Communications Commission v Consumers' Research next month, potentially reviving the long-dormant nondelegation...
Just when you thought the dust had settled from the Chevron decision, the Supreme Court is gearing up to hear arguments in Federal Communications Commission v Consumers' Research next month, potentially reviving the long-dormant nondelegation...
Just when you thought the dust...
02/12/2025
First Report Managed Care
Behind the Bill
No, President Trump Did Not Actually Sign an Executive Order That Would Increase Drug Costs for Beneficiaries
02/05/2025
Katie Hayes, MJ
On inauguration day, President Trump issued an executive order rescinding several Biden-era health care initiatives, including 3 experimental drug pricing models developed by the Center for Medicare and Medicaid Innovation (CMMI). Oh boy did...
On inauguration day, President Trump issued an executive order rescinding several Biden-era health care initiatives, including 3 experimental drug pricing models developed by the Center for Medicare and Medicaid Innovation (CMMI). Oh boy did...
On inauguration day, President...
02/05/2025
First Report Managed Care
Behind the Bill
Robert F. Kennedy Jr’s Confirmation and the Unexpected Turn in the Drug Pricing Debate
01/29/2025
Katie Hayes, MJ
The Plot Thickens in Drug Pricing Drama Just when you thought the drug pricing debate couldn't get more interesting, Robert F. Kennedy Jr adds an unexpected twist. During closed-door Senate meetings, President Trump’s US Department of...
The Plot Thickens in Drug Pricing Drama Just when you thought the drug pricing debate couldn't get more interesting, Robert F. Kennedy Jr adds an unexpected twist. During closed-door Senate meetings, President Trump’s US Department of...
The Plot Thickens in Drug...
01/29/2025
First Report Managed Care

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Trending Articles

News
Long-Wave Infrared Thermography Helps LTACH Achieve Pressure Injury Success
04/25/2023
Jolynn Tumolo
“The LTACH facility maintained a zero hospital-acquired pressure injury rate for 10 months after implementation of long-wave infrared thermography," researchers reported.
“The LTACH facility maintained a zero hospital-acquired pressure injury rate for 10 months after implementation of long-wave infrared thermography," researchers reported.
“The LTACH facility maintained a...
04/25/2023
First Report Managed Care
Headshot of Barbara Konkle, MD, on a blue background underneath the PopHealth Perspectives logo.
Podcasts
Discussing a Novel Factor VIII Replacement Therapy for Patients With Hemophilia
05/24/2023
Maria Asimopoulos
Barbara Konkle, MD, professor of medicine, Division of Hematology, University of Washington; research director, Washington Center for Bleeding Disorders; and director, Hemostasis, Platelet Immunology and Genomics Laboratory at Bloodworks...
Barbara Konkle, MD, professor of medicine, Division of Hematology, University of Washington; research director, Washington Center for Bleeding Disorders; and director, Hemostasis, Platelet Immunology and Genomics Laboratory at Bloodworks...
Barbara Konkle, MD, professor of...
05/24/2023
First Report Managed Care
Formulary Frontlines®
Challenges, Treatment Options, and Costs Linked With Upper Tract Urothelial Carcinoma
06/20/2023
Julie Gould
Bladder cancer was the sixth most common cancer type in the United States in 2020, behind breast, lung, prostate, colon, and skin cancers.
Bladder cancer was the sixth most common cancer type in the United States in 2020, behind breast, lung, prostate, colon, and skin cancers.
Bladder cancer was the sixth...
06/20/2023
First Report Managed Care
News
Medicare Could Save $1 Billion by Considering Added Benefit of Expensive Part B Drugs
07/18/2023
Jolynn Tumolo
Researchers find that Medicare could potentially save $1 billion by considering the added therapeutic benefit of expensive Part B drugs and implementing reference pricing.
Researchers find that Medicare could potentially save $1 billion by considering the added therapeutic benefit of expensive Part B drugs and implementing reference pricing.
Researchers find that Medicare...
07/18/2023
First Report Managed Care
News
New Platform Leverages Real-World Evidence for Type 2 Inflammation Immunological Disease Research
08/07/2023
Hannah Musick
Researchers introduce Immunolab, a platform that generates real-world evidence to provide insights and conduct research on immunological diseases related to type 2 inflammation.
Researchers introduce Immunolab, a platform that generates real-world evidence to provide insights and conduct research on immunological diseases related to type 2 inflammation.
Researchers introduce Immunolab,...
08/07/2023
First Report Managed Care

April 2015 Volume 12 Issue 4

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