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January 2016 - FRMC

New Treatment Option for HYPERKALEMIA: patiromer
02/02/2016
Patients with CKD and hyperkalemia found that treatment with patiromer was associated with a reduction in serum potassium levels and a reduction in recurrence.
Patients with CKD and hyperkalemia found that treatment with patiromer was associated with a reduction in serum potassium levels and a reduction in recurrence.
Patients with CKD and...
02/02/2016
First Report Managed Care
Department
Product Update
02/02/2016
The FDA approved Zurampic (lesinurad) used in combination with a xanthine oxidase inhibitor (XOI) to treat hyperuricemia associated with gout. XOI is used to reduce the production of uric acid in the body.
The FDA approved Zurampic (lesinurad) used in combination with a xanthine oxidase inhibitor (XOI) to treat hyperuricemia associated with gout. XOI is used to reduce the production of uric acid in the body.
The FDA approved Zurampic...
02/02/2016
First Report Managed Care
NON–SMALL-CELL LUNG CANCER: Shifting from Generic Chemotherapy Regimens to Complex Treatment Landscapes
02/02/2016
Eileen Koutnik-Fotopoulos
With new drugs targeting second-line therapy, a crowded treatment algorithm may be on the horizon for patients with NSCLC. 
With new drugs targeting second-line therapy, a crowded treatment algorithm may be on the horizon for patients with NSCLC. 
With new drugs targeting...
02/02/2016
First Report Managed Care
Specialty Drugs: The Tipping Point is Coming
02/02/2016
Eileen Koutnik-Fotopoulos
Payer clients are faced with alarmingly high-cost specialty drug trends with no clear direction on how to balance the dilemma of therapy versus cost. Add the explosive development of new specialty drugs over the next few years and payers...
Payer clients are faced with alarmingly high-cost specialty drug trends with no clear direction on how to balance the dilemma of therapy versus cost. Add the explosive development of new specialty drugs over the next few years and payers...
Payer clients are faced with...
02/02/2016
First Report Managed Care
US Just Scratching Surface of Biosimilar Landscape
02/02/2016
Eileen Koutnik-Fotopoulos
Now that the first biosimilar—filgrastim-sndz—has entered the US marketplace, policies and perceptions around these complex medicines are unfurling.
Now that the first biosimilar—filgrastim-sndz—has entered the US marketplace, policies and perceptions around these complex medicines are unfurling.
Now that the first...
02/02/2016
First Report Managed Care
Should Medicare Negotiate Drug Prices?
02/02/2016
Dean Celia
Drug costs are a top concern for voters, with polls showing that most are open to letting Medicare tackle the issue by negotiating drug prices. Here’s where the presidential candidates stand and what our experts believe are the potential...
Drug costs are a top concern for voters, with polls showing that most are open to letting Medicare tackle the issue by negotiating drug prices. Here’s where the presidential candidates stand and what our experts believe are the potential...
Drug costs are a top concern...
02/02/2016
First Report Managed Care
New Breast Cancer Guidelines and Managed Care
02/02/2016
Dean Celia
The American Cancer Society's revised guidelines have inched closer to United States Preventive Services Task Force recommendations. How will this impact managed care? Our experts sort through the potential effect on Accountable Care...
The American Cancer Society's revised guidelines have inched closer to United States Preventive Services Task Force recommendations. How will this impact managed care? Our experts sort through the potential effect on Accountable Care...
The American Cancer...
02/02/2016
First Report Managed Care
Embracing Change: As the Number of Public and Private ACOs Grow, Lessons Emerge
02/02/2016
Jill Sederstorm
The momentum to establish accountable care organizations (ACOs) continues to grow, as both government and commercial payers make a push for providers to begin baring risk for patient populations. 
The momentum to establish accountable care organizations (ACOs) continues to grow, as both government and commercial payers make a push for providers to begin baring risk for patient populations. 
The momentum to establish...
02/02/2016
First Report Managed Care
Hello, Goodbye—Implications of UnitedHealth`s Potentially Quick ACA Exit
02/02/2016
Paul Nicolaus
Is a fundamental structural issue with the exchange products overall to blame? Our experts think only time will tell. 
Is a fundamental structural issue with the exchange products overall to blame? Our experts think only time will tell. 
Is a fundamental structural...
02/02/2016
First Report Managed Care
Challenges in Oncology Care Management
02/02/2016
Jill Sederstorm
The percentage of MCOs using guidelines and pathways to direct cancer treatment is on the rise. 
The percentage of MCOs using guidelines and pathways to direct cancer treatment is on the rise. 
The percentage of MCOs using...
02/02/2016
First Report Managed Care

Behind the Bill

Behind the Bill
The Bitter Pill: How Tariffs Could Make Generics Less Affordable
04/09/2025
Katie Hayes, MJ
As President Donald Trump’s administration introduces a series of tariffs aimed at rebalancing trade and boosting US manufacturing, one sector in particular is watching closely: pharmaceuticals. While drugs themselves may not be directly...
As President Donald Trump’s administration introduces a series of tariffs aimed at rebalancing trade and boosting US manufacturing, one sector in particular is watching closely: pharmaceuticals. While drugs themselves may not be directly...
As President Donald Trump’s...
04/09/2025
First Report Managed Care
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

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Commentary
2024 CMS Final Rule: Focus on the Health Equity Index Reward
05/04/2023
Cory Busse
In this commentary, Cory Busse, vice president, sales and strategic solutions, Icario, shares insight into the Health Equity Index (HEI) reward in the 2024 CMS Final Rule and what Medicare Advantage plans should do next.
In this commentary, Cory Busse, vice president, sales and strategic solutions, Icario, shares insight into the Health Equity Index (HEI) reward in the 2024 CMS Final Rule and what Medicare Advantage plans should do next.
In this commentary, Cory Busse,...
05/04/2023
First Report Managed Care
News
How Did Payer Shifts Impact Veteran Access to Private Care?
05/30/2023
Julie Gould
Researchers explain, “Leveraging a novel dataset, we demonstrate that MISSION Act implementation coincided with a shift in the financing of non-VA ED visits from Medicare to VA without any increase in overall ED utilization.”
Researchers explain, “Leveraging a novel dataset, we demonstrate that MISSION Act implementation coincided with a shift in the financing of non-VA ED visits from Medicare to VA without any increase in overall ED utilization.”
Researchers explain, “Leveraging...
05/30/2023
First Report Managed Care
News
BMI Improvement With Liraglutide Possible in Teens Regardless of Baseline Traits
06/23/2023
Jolynn Tumolo
“These results suggest that liraglutide may be a relevant treatment option for adolescents with obesity with an insufficient response to lifestyle therapy, irrespective of baseline characteristics,” wrote corresponding author Megan O...
“These results suggest that liraglutide may be a relevant treatment option for adolescents with obesity with an insufficient response to lifestyle therapy, irrespective of baseline characteristics,” wrote corresponding author Megan O...
“These results suggest that...
06/23/2023
First Report Managed Care
News
CNS Prophylaxis Shows Limited Effectiveness in Preventing CNS Relapse in DLBCL
07/21/2023
Jolynn Tumolo
In addition to effectiveness, researchers also evaluated the financial toxicity and side effects associated with CNS prophylaxis for patients with diffuse large B-cell lymphoma. 
In addition to effectiveness, researchers also evaluated the financial toxicity and side effects associated with CNS prophylaxis for patients with diffuse large B-cell lymphoma. 
In addition to effectiveness,...
07/21/2023
First Report Managed Care
News
Long-Acting Injectable Antiretroviral Could "Help End AIDS"
08/15/2023
Jolynn Tumolo
A coordinated effort involving governments, large funders, and manufacturers is essential for the rollout of long-acting and extended-delivery antiretroviral medication to effectively fight against the HIV epidemic, according to a commentary...
A coordinated effort involving governments, large funders, and manufacturers is essential for the rollout of long-acting and extended-delivery antiretroviral medication to effectively fight against the HIV epidemic, according to a commentary...
A coordinated effort involving...
08/15/2023
First Report Managed Care

January 2016 Volume 13 Issue 1

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