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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
Mary Beth Nierengarten
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
David Costill
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

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
Authors Call for Novel, Integrated Approaches in RSV Therapeutic Research
04/27/2023
Jolynn Tumolo
In addition to encouraging increased collaboration between bioinformaticians and pharmacologists, the authors recommended the use of new approaches such as nanotechnology, molecular inhibitors, and more.
In addition to encouraging increased collaboration between bioinformaticians and pharmacologists, the authors recommended the use of new approaches such as nanotechnology, molecular inhibitors, and more.
In addition to encouraging...
04/27/2023
Pharmacy Learning Network
News
Examining the Link Between Emergency Department Use and Insurance Coverage
05/26/2023
Julie Gould
“Although Medicaid expansion has provided increased health care coverage for many previously uninsured patients, prior literature suggests that health care utilization and public spending increase with government insurance coverage,” wrote...
“Although Medicaid expansion has provided increased health care coverage for many previously uninsured patients, prior literature suggests that health care utilization and public spending increase with government insurance coverage,” wrote...
“Although Medicaid expansion has...
05/26/2023
First Report Managed Care
Quiz
RSV Vaccine Eligibility
06/21/2023
What patient demographic can now receive the FDA-approved RSV vaccine Arexvy?
What patient demographic can now receive the FDA-approved RSV vaccine Arexvy?
What patient demographic can now...
06/21/2023
First Report Managed Care
News
Men and Women With MS Perceive Functional Trajectories Differently
07/19/2023
Jolynn Tumolo
“A gap in research about the trajectories of function among men and women aging with functional limitations because of MS hinders ability to plan for future needs,” said researchers. 
“A gap in research about the trajectories of function among men and women aging with functional limitations because of MS hinders ability to plan for future needs,” said researchers. 
“A gap in research about the...
07/19/2023
First Report Managed Care
News
RSV Prefusion F Vaccine Prevents RSV Illness in Older Adults
08/10/2023
Jolynn Tumolo
Recent clinical trial findings indicate that the RSVpreF vaccine demonstrated efficacy in preventing RSV-associated respiratory illnesses in older adults with no significant safety concerns.
Recent clinical trial findings indicate that the RSVpreF vaccine demonstrated efficacy in preventing RSV-associated respiratory illnesses in older adults with no significant safety concerns.
Recent clinical trial findings...
08/10/2023
First Report Managed Care

September 2018 Volume 15 Issue 9

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