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October 2016 - FRMC

Featured Article

House of Cards: How Much Longer Can the ACA Hold Up?
10/20/2016
Paul Nicolaus
With insurers pulling out, premiums on the rise, and the presidential election on the way, the fate of Obamacare hangs in the balance. 
With insurers pulling out, premiums on the rise, and the presidential election on the way, the fate of Obamacare hangs in the balance. 
With insurers pulling out,...
10/20/2016
First Report Managed Care

Department

News Connection
Alternative Management Strategies Achieve Comparable Clinical Outcomes
11/20/2016
A recently published review suggests that alternatives to inpatient hospitalization do not jeopardize the treatment of several acute medical conditions.
A recently published review suggests that alternatives to inpatient hospitalization do not jeopardize the treatment of several acute medical conditions.
A recently published review...
11/20/2016
First Report Managed Care
Managed Care Q&A
Implementing Value-Based Care Through Clinically Integrated Organizations
10/20/2016
David Costill
An interview with Chad Johnson, senior vice president and executive director, Phoenix Children’s Care Network.
An interview with Chad Johnson, senior vice president and executive director, Phoenix Children’s Care Network.
An interview with Chad...
10/20/2016
First Report Managed Care
News Connection
Republican Lawmakers Warn of MACRA’s Impact on Small Practices
10/20/2016
A group of Republican lawmakers are urging the Centers for Medicare and Medicaid Services (CMS) to revise its proposed implementation of the Medicare Access and CHIP Reauthorization Act, or MACRA, of 2015, which they argue would complicate...
A group of Republican lawmakers are urging the Centers for Medicare and Medicaid Services (CMS) to revise its proposed implementation of the Medicare Access and CHIP Reauthorization Act, or MACRA, of 2015, which they argue would complicate...
A group of Republican lawmakers...
10/20/2016
First Report Managed Care
News Connection
Investigation Reveals "Gross Mismanagement" to Blame for Denver VA Facility`s Exorbitant Cost
10/20/2016
An internal investigation by the US Department of Veterans’ Affairs (VA) found that the bloated budget and costly delays for construction of a new VA medical campus near Denver, Colorado were caused by gross mismanagement.
An internal investigation by the US Department of Veterans’ Affairs (VA) found that the bloated budget and costly delays for construction of a new VA medical campus near Denver, Colorado were caused by gross mismanagement.
An internal investigation by the...
10/20/2016
First Report Managed Care
News Connection
Non-TNF-targeted Biologics Most Effective After RA Treatment Failure
10/20/2016
According to recent research, for rheumatoid arthritis patients who have failed initial anti-tumor necrosis factor therapy, care providers should consider a non–TNF-targeted biologic due to a an effictive clinical response.
According to recent research, for rheumatoid arthritis patients who have failed initial anti-tumor necrosis factor therapy, care providers should consider a non–TNF-targeted biologic due to a an effictive clinical response.
According to recent research,...
10/20/2016
First Report Managed Care
News Connection
Malnutrition Contributes $15.5 Billion to Nationwide Medical Spending Annually
10/20/2016
Malnutrition associated with disease is responsible for more than $15.5 billion in direct medical costs each year, and is disproportionately driven by patients aged 65 years or older, according to an economic analysis recently published in...
Malnutrition associated with disease is responsible for more than $15.5 billion in direct medical costs each year, and is disproportionately driven by patients aged 65 years or older, according to an economic analysis recently published in...
Malnutrition associated with...
10/20/2016
First Report Managed Care
News Connection
MI Survival Rates Extended at High-Performing Hospitals
10/20/2016
A recent analysis suggests myocardial infarction patients who were treated in health care institutions that demonstrated favorable 30-day risk-standardized mortality rates, also had longer life expectancies when compared to patients who were...
A recent analysis suggests myocardial infarction patients who were treated in health care institutions that demonstrated favorable 30-day risk-standardized mortality rates, also had longer life expectancies when compared to patients who were...
A recent analysis suggests...
10/20/2016
First Report Managed Care
Orphan Drugs: Rare Disease Treatments Becoming Commonplace
10/20/2016
Mary Beth Nierengarten
As the popularity of rare-disease indicated orphan drugs increases, payers are becoming concerned about whether or not these prescriptions are entirely necessary.
As the popularity of rare-disease indicated orphan drugs increases, payers are becoming concerned about whether or not these prescriptions are entirely necessary.
As the popularity of...
10/20/2016
First Report Managed Care
Presidential Plans to Fix Drug Pricing: Would Either Work?
10/20/2016
Dean Celia
Recent controversy related to drug price gouging has pushed the issue onto the political stage in the midst of the 2016 Presidential election. Each candidate has taken a stance against allowing drug companies to unnecessarily raise prices to...
Recent controversy related to drug price gouging has pushed the issue onto the political stage in the midst of the 2016 Presidential election. Each candidate has taken a stance against allowing drug companies to unnecessarily raise prices to...
Recent controversy related to...
10/20/2016
First Report Managed Care

News

News
Untangling the Mylan EpiPen Controversy
10/20/2016
Dean Celia
After public backlash against exorbitant price increases for the EpiPen, industry leaders are weighing in on the practicality of the new price and the validity of possible solutions presented by its manufacturer.
After public backlash against exorbitant price increases for the EpiPen, industry leaders are weighing in on the practicality of the new price and the validity of possible solutions presented by its manufacturer.
After public backlash against...
10/20/2016
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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Current Understandings of Disease Mechanisms and Therapeutic Approaches in Multiple Sclerosis
10/23/2024
Juliet Gallagher
A comprehensive review of multiple sclerosis causes, forms, and treatments.
A comprehensive review of multiple sclerosis causes, forms, and treatments.
A comprehensive review of...
10/23/2024
First Report Managed Care
News
Monoclonal Antibody Improves Type 2 Inflammation Biomarkers in Children With Asthma
04/21/2023
Jolynn Tumolo
Findings from a phase 3 study suggest two dose regimens of a monoclonal antibody were similarly efficacious for reducing type 2 inflammatory biomarkers in pediatric patients with asthma.
Findings from a phase 3 study suggest two dose regimens of a monoclonal antibody were similarly efficacious for reducing type 2 inflammatory biomarkers in pediatric patients with asthma.
Findings from a phase 3 study...
04/21/2023
First Report Managed Care
News
Survival Disparity Persists Between Black and White Patients With CLL
05/19/2023
Jolynn Tumolo
When compared to White patients, Black patients with chronic lymphocytic leukemia face a persistent survival disadvantage that is not found among other racial minority groups, researchers reported.
When compared to White patients, Black patients with chronic lymphocytic leukemia face a persistent survival disadvantage that is not found among other racial minority groups, researchers reported.
When compared to White patients,...
05/19/2023
First Report Managed Care
News
Therapy Improves Type 2 Asthma Outcomes Regardless of Allergic Status
06/09/2023
Jolynn Tumolo
Researchers found that long-term treatment with dupilumab improved outcomes in patients with moderate-to-severe GINA-based type 2 asthma, regardless of allergic status.
Researchers found that long-term treatment with dupilumab improved outcomes in patients with moderate-to-severe GINA-based type 2 asthma, regardless of allergic status.
Researchers found that long-term...
06/09/2023
First Report Managed Care
News
Measuring RSV Risk Awareness Among Adults With Diabetes
07/07/2023
Julie Gould
Researchers explored knowledge, attitudes, and perceptions of respiratory syncytial virus (RSV) risk among US adults with diabetes to inform health care provider education efforts related to RSV awareness.
Researchers explored knowledge, attitudes, and perceptions of respiratory syncytial virus (RSV) risk among US adults with diabetes to inform health care provider education efforts related to RSV awareness.
Researchers explored knowledge,...
07/07/2023
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