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September 2018 - First Report Managed Care

Featured Article

Hospitals Brace for Impact of 340B Drug Pricing Program Changes
09/14/2018
Since the implementation of changes to the 340B Drug Pricing program in January 2018, a long, growing debate over the merits and problems with the program has only strengthened. 
Since the implementation of changes to the 340B Drug Pricing program in January 2018, a long, growing debate over the merits and problems with the program has only strengthened. 
Since the implementation of...
09/14/2018
First Report Managed Care

Department

Managed Care Q&A
Improving Access Through Walgreens New Digital Platform
09/18/2018
Giovanni Monti, MBA, MIA, Walgreens Boots Alliance vice president, and director of Healthcare Innovation, discusses the new platform created by Walgreens—Find Care Now—and explains how it will expand access to care for patients and also...
Giovanni Monti, MBA, MIA, Walgreens Boots Alliance vice president, and director of Healthcare Innovation, discusses the new platform created by Walgreens—Find Care Now—and explains how it will expand access to care for patients and also...
Giovanni Monti, MBA, MIA,...
09/18/2018
First Report Managed Care
News Connection
CVS Shifts to ICER Value-Based Drug Pricing Strategy
09/18/2018
CVS Caremark will shift to using the Institute for Clinical and Economic Review’s (ICER) value-based drug pricing system, which excludes some high-cost drugs from health plans, a white paper from CVS explained.
CVS Caremark will shift to using the Institute for Clinical and Economic Review’s (ICER) value-based drug pricing system, which excludes some high-cost drugs from health plans, a white paper from CVS explained.
CVS Caremark will shift to using...
09/18/2018
First Report Managed Care
News Connection
Prescription Drug Costs Account for 15% of Total Health Care Spending
09/18/2018
Despite the frequent claim by the industry that 10% of spending goes toward pharmaceuticals, a new report published online in Health Affairs suggests that prescription drugs may actually account for roughly 15% of all money spent on total...
Despite the frequent claim by the industry that 10% of spending goes toward pharmaceuticals, a new report published online in Health Affairs suggests that prescription drugs may actually account for roughly 15% of all money spent on total...
Despite the frequent claim by...
09/18/2018
First Report Managed Care
News Connection
CMS Increases Pricing Transparency, Requires Hospitals to Post Prices Online
09/18/2018
The Centers for Medicare and Medicaid Services (CMS) has issued a final rule on the Inpatient Prospective Payment System (IPPS) that increases pricing transparency by pushing hospitals to post standard charges online in a machine-readable...
The Centers for Medicare and Medicaid Services (CMS) has issued a final rule on the Inpatient Prospective Payment System (IPPS) that increases pricing transparency by pushing hospitals to post standard charges online in a machine-readable...
The Centers for Medicare and...
09/18/2018
First Report Managed Care
News Connection
Express Scripts Announces Formulary Exclusions for 2019, Drops Nearly 50 Drugs
09/18/2018
The nation’s largest pharmacy benefit manager, Express Scripts, has announced they will drop approximately 48 drugs in 2019 from its current lineup of covered drugs, according to a company press release.
The nation’s largest pharmacy benefit manager, Express Scripts, has announced they will drop approximately 48 drugs in 2019 from its current lineup of covered drugs, according to a company press release.
The nation’s largest pharmacy...
09/18/2018
First Report Managed Care
News Connection
CMS Announces Strategy to Lower Medicare Advantage Costs
09/18/2018
In an effort to negotiate better deals for Medicare patients and create competition between drugs used to treat the same conditions, the Centers for Medicare and Medicaid Services (CMS) has announced they will shift more than half of the...
In an effort to negotiate better deals for Medicare patients and create competition between drugs used to treat the same conditions, the Centers for Medicare and Medicaid Services (CMS) has announced they will shift more than half of the...
In an effort to negotiate better...
09/18/2018
First Report Managed Care
News Connection
VA Secretary Clarifies Collective Bargaining Authority Relating to Patient Care
09/18/2018
Robert Wilkie, department of Veteran Affairs (VA) secretary, recently clarified that unions can no longer use collective bargaining rights when it comes to professional conduct and patient care by VA providers.
Robert Wilkie, department of Veteran Affairs (VA) secretary, recently clarified that unions can no longer use collective bargaining rights when it comes to professional conduct and patient care by VA providers.
Robert Wilkie, department of...
09/18/2018
First Report Managed Care
News Connection
VA, Walgreens Announce Collaboration
09/18/2018
In an effort to improve care coordination for veterans, the Department of Veteran Affairs (VA) has announced it will work with Walgreens to coordinate patient and pharmaceutical care for VA-enrolled patients. 
In an effort to improve care coordination for veterans, the Department of Veteran Affairs (VA) has announced it will work with Walgreens to coordinate patient and pharmaceutical care for VA-enrolled patients. 
In an effort to improve care...
09/18/2018
First Report Managed Care
News Connection
Ahead of VA MISSION Act Expansion, Caregiver Program Requires Attention
09/18/2018
According to a recent analysis from the Department of Veteran Affairs (VA) Office of Inspector General (OIG), the VA has not adequately monitored its Caregiver Assistance Program, which has resulted in patient care access limitations and...
According to a recent analysis from the Department of Veteran Affairs (VA) Office of Inspector General (OIG), the VA has not adequately monitored its Caregiver Assistance Program, which has resulted in patient care access limitations and...
According to a recent analysis...
09/18/2018
First Report Managed Care
Conference Insider
Meeting Preview: What to Expect at HQC 2018
09/18/2018
The 2018 Health Care Quality Congress (HQC) is a new national meeting by the National Committee for Quality Assurance (NCQA) that will take place October 5–7 at the Hyatt Regency in Dallas, TX. 
The 2018 Health Care Quality Congress (HQC) is a new national meeting by the National Committee for Quality Assurance (NCQA) that will take place October 5–7 at the Hyatt Regency in Dallas, TX. 
The 2018 Health Care Quality...
09/18/2018
First Report Managed Care
FRMC Volume 21, Issue 3

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Is Trump Pushing Health Insurance Innovation or an ACA Rollback?
11/30/2018
The Trump administration offered states specific examples of how they could change the way they implement the Affordable Care Act.
The Trump administration offered states specific examples of how they could change the way they implement the Affordable Care Act.
The Trump administration offered...
11/30/2018
First Report Managed Care
News
H1N1 pandemic is over, health director says
08/11/2010
08/11/2010
First Report Managed Care
Hospital Star Wars: Sounding Off on the New CMS Star Ratings
02/09/2017
In an interview last year, Gary Owens, MD, noted that "star ratings work better for restaurants and movies.”
In an interview last year, Gary Owens, MD, noted that "star ratings work better for restaurants and movies.”
In an interview last year, Gary...
02/09/2017
First Report Managed Care
Risk Adjustment Data Validation (RADV) Audits Just Got Real
02/20/2015
Last night the second-largest Medicare Advantage plan in the country, Humana, filed an SEC document detailing a US Department of Justice investigation into the company’s risk adjustment coding and data collection practices.  The investigation...
Last night the second-largest Medicare Advantage plan in the country, Humana, filed an SEC document detailing a US Department of Justice investigation into the company’s risk adjustment coding and data collection practices.  The investigation...
Last night the second-largest...
02/20/2015
First Report Managed Care
News
Featured Sessions at AHS 2018
11/14/2018
The Scottsdale Headache Symposium offers a variety of sessions and educational objectives to help attendees gain a better understanding of headache treatment.
The Scottsdale Headache Symposium offers a variety of sessions and educational objectives to help attendees gain a better understanding of headache treatment.
The Scottsdale Headache...
11/14/2018
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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