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Volume 16, Issue 10, October 2019 - First Report Managed Care

Featured Article

What are the Democratic Candidates Really Saying About Health Care?
10/17/2019
Dean Celia
As candidates continue to debate health care, our experts took a look beyond the rhetoric and main talking points of five of the leading democratic contenders to analyze what they are—and potentially are not—telling payers, providers, and...
As candidates continue to debate health care, our experts took a look beyond the rhetoric and main talking points of five of the leading democratic contenders to analyze what they are—and potentially are not—telling payers, providers, and...
As candidates continue to debate...
10/17/2019
First Report Managed Care
New Payment Models Tackle Medicaid Drug Spending
10/17/2019
Paul Nicolaus
Several states are pursuing alternative payment models for prescription drugs to curb spending and address public health crises, but experts say these new strategies face a variety of challenges on their way to implementation.
Several states are pursuing alternative payment models for prescription drugs to curb spending and address public health crises, but experts say these new strategies face a variety of challenges on their way to implementation.
Several states are pursuing...
10/17/2019
First Report Managed Care
The Compassion of Care: Benefits to Patients and Providers
10/17/2019
Mary Beth Nierengarten
As politics continue to play an ever-present role in the future of health care, providers, patients, plans, and other professionals are looking for ways to improve care quality and build meaningful, successful connections among their care...
As politics continue to play an ever-present role in the future of health care, providers, patients, plans, and other professionals are looking for ways to improve care quality and build meaningful, successful connections among their care...
As politics continue to play an...
10/17/2019
First Report Managed Care

Department

Conference Insider
Understanding the Importance of Partnerships in Health Care
10/17/2019
Ambria Moore, BA, PMP, and Denise Parker, both delegate oversight project managers at BlueCross BlueShield (BCBS) of Tennessee, provided tips and techniques for professionals to keep organizations engaged, accountable, and in an ongoing state...
Ambria Moore, BA, PMP, and Denise Parker, both delegate oversight project managers at BlueCross BlueShield (BCBS) of Tennessee, provided tips and techniques for professionals to keep organizations engaged, accountable, and in an ongoing state...
Ambria Moore, BA, PMP, and...
10/17/2019
First Report Managed Care
Conference Insider
How Population Health and Care Quality Relate
10/17/2019
David Nash, MD, MBA, launched the second annual Health Care Quality Congress 2019 with his session entitled, “Population Health and Quality: Two Peas in a Pod,” where he discussed how managing population health can help improve health care...
David Nash, MD, MBA, launched the second annual Health Care Quality Congress 2019 with his session entitled, “Population Health and Quality: Two Peas in a Pod,” where he discussed how managing population health can help improve health care...
David Nash, MD, MBA, launched...
10/17/2019
First Report Managed Care
Conference Insider
What is the Collaborative Care Model and How Does it Work?
10/17/2019
Nicole Andrews, MPH, PCDC, recently discussed the elements of the collaborative care model at Heath Care Quality Congress 2019, and she explained the models impact on health care cost and analyzed payment incentives for integrating the model.
Nicole Andrews, MPH, PCDC, recently discussed the elements of the collaborative care model at Heath Care Quality Congress 2019, and she explained the models impact on health care cost and analyzed payment incentives for integrating the model.
Nicole Andrews, MPH, PCDC,...
10/17/2019
First Report Managed Care
Conference Insider
Interview: Care Coordinators Improve Care Quality
10/17/2019
Lori Francis, MBA, PCMH CCE, a program management specialist at BlueCross BlueShield recently spoke with First Report Managed Care at Health Care Quality Congress 2019, on the benefits of using embedded care coordinators to improve physician...
Lori Francis, MBA, PCMH CCE, a program management specialist at BlueCross BlueShield recently spoke with First Report Managed Care at Health Care Quality Congress 2019, on the benefits of using embedded care coordinators to improve physician...
Lori Francis, MBA, PCMH CCE, a...
10/17/2019
First Report Managed Care
Conference Insider
Implementing PROMs in Primary Care and Understanding Chronic Pain
10/17/2019
Sarah Hudson Scholle, MPH, DrPH, and Daren Anderson, MD, addressed issues surrounding the implementation of patient-reported outcome measures (PROM) in the primary care setting.
Sarah Hudson Scholle, MPH, DrPH, and Daren Anderson, MD, addressed issues surrounding the implementation of patient-reported outcome measures (PROM) in the primary care setting.
Sarah Hudson Scholle, MPH, DrPH,...
10/17/2019
First Report Managed Care
Conference Insider
Strategies for Integrating Behavioral Health Distinction With PCMH
10/17/2019
During one of the sessions at PCMH Congress 2019, Rebecca Durday, MPH, PCMH, CCE, practice advancement strategies, Healthcare Association for New York State, explained the importance of integrating behavioral health into primary care and...
During one of the sessions at PCMH Congress 2019, Rebecca Durday, MPH, PCMH, CCE, practice advancement strategies, Healthcare Association for New York State, explained the importance of integrating behavioral health into primary care and...
During one of the sessions at...
10/17/2019
First Report Managed Care
Conference Insider
Improving Patient Care, Reducing Health Care Burden Through Physician, Health IT Partnerships
10/17/2019
Shivani Malhotra, MD FAAFP, associate program director & assistant professor family medicine, and Emily Leviner, MEd, system administrator, both from The University Of Alabama at Birmingham School of Medicine, recently discussed the adoption...
Shivani Malhotra, MD FAAFP, associate program director & assistant professor family medicine, and Emily Leviner, MEd, system administrator, both from The University Of Alabama at Birmingham School of Medicine, recently discussed the adoption...
Shivani Malhotra, MD FAAFP,...
10/17/2019
First Report Managed Care
Formulary Frontlines®
CGRP Inhibitors May Offer Significant Benefits for Migraine Patients
10/17/2019
Jeff Craven
With the advent of calcitonin gene-related peptide (CGRP) inhibitors, which are either monoclonal antibodies or CGRP receptor agonists that block CGRP proteins in the head and neck, another treatment option has emerged for patients where...
With the advent of calcitonin gene-related peptide (CGRP) inhibitors, which are either monoclonal antibodies or CGRP receptor agonists that block CGRP proteins in the head and neck, another treatment option has emerged for patients where...
With the advent of calcitonin...
10/17/2019
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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First Report Managed Care
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First Report Managed Care
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October 2019 Volume 16 Issue 10

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