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Volume 17, Issue 8, September 2020 - First Report Managed Care

Featured Article

Health Care on the Ballot: Four More Years or a New Direction?
09/25/2020
Dean Celia
How is the health care landscape expected to look over the next four years? We consulted with managed care experts to analyze what has changed since 2016, what is likely to occur if the president is reelected, and how events might unfold...
How is the health care landscape expected to look over the next four years? We consulted with managed care experts to analyze what has changed since 2016, what is likely to occur if the president is reelected, and how events might unfold...
How is the health care landscape...
09/25/2020
First Report Managed Care

Department

Formulary Frontlines®
Achieving Effective Motor Control for Patients With Parkinson Disease
09/25/2020
Edan Stanley
There is no definitive cure for PD but the main objective is reducing symptoms and achieving effective motor control through medication and surgical therapy. The cornerstone of symptomatic treatment for PD is dopamine replacement therapy.
There is no definitive cure for PD but the main objective is reducing symptoms and achieving effective motor control through medication and surgical therapy. The cornerstone of symptomatic treatment for PD is dopamine replacement therapy.
There is no definitive cure for...
09/25/2020
First Report Managed Care
Managed Care Q&A
Refocusing the Multiple Sclerosis Treatment Landscape
09/25/2020
Edan Stanley
Edmund Pezalla, MD, MPH, CEO of Enlightenment Bioconsult, formerly of Aetna, discusses treatment options for multiple sclerosis (MS), highlights results from the ASCLEPIOS I and II studies, and notes why this data can be useful for payers. Dr...
Edmund Pezalla, MD, MPH, CEO of Enlightenment Bioconsult, formerly of Aetna, discusses treatment options for multiple sclerosis (MS), highlights results from the ASCLEPIOS I and II studies, and notes why this data can be useful for payers. Dr...
Edmund Pezalla, MD, MPH, CEO of...
09/25/2020
First Report Managed Care
News Connection
Examining Access to Home Health Care During Pandemic
09/25/2020
In a recent study published in JAMA Network Open, researchers assessed patient access and utilization of home health care, post-hospital discharge. Results showed a number of barriers including socioeconomic disparities.
In a recent study published in JAMA Network Open, researchers assessed patient access and utilization of home health care, post-hospital discharge. Results showed a number of barriers including socioeconomic disparities.
In a recent study published in...
09/25/2020
First Report Managed Care
News Connection
Nearly 12 Million People Lost Employer-Sponsored Insurance Amid Pandemic
09/25/2020
It is no surprise that many Americans lost access to health insurance throughout the pandemic, but new data shows that nearly 12 million people have been cut off from employee-sponsored plans.
It is no surprise that many Americans lost access to health insurance throughout the pandemic, but new data shows that nearly 12 million people have been cut off from employee-sponsored plans.
It is no surprise that many...
09/25/2020
First Report Managed Care
News Connection
Hospitalization Predictors of Readmission for Psoriasis
09/25/2020
US patients hospitalized for psoriasis had high rates of hospital readmission overall, but low rates of readmission for psoriasis specifically, according to a study published in the Journal of the American Academy of Dermatology.
US patients hospitalized for psoriasis had high rates of hospital readmission overall, but low rates of readmission for psoriasis specifically, according to a study published in the Journal of the American Academy of Dermatology.
US patients hospitalized for...
09/25/2020
First Report Managed Care
News Connection
Examining Trends in ED Costs of Care for Medicare Beneficiaries
09/25/2020
According to results of a recent JAMA Network Open study, total 30-day costs of emergency department (ED) care for Medicare beneficiaries has decreased over the last several years, which the authors mostly attribute to declining rates of...
According to results of a recent JAMA Network Open study, total 30-day costs of emergency department (ED) care for Medicare beneficiaries has decreased over the last several years, which the authors mostly attribute to declining rates of...
According to results of a recent...
09/25/2020
First Report Managed Care
News Connection
Quality of Life Significantly Lower With Chronic Lymphocytic Leukemia
09/25/2020
Whether on watch-and-wait or treatment regimens, patients with chronic lymphocytic leukemia had significantly impaired quality of life compared with age-matched healthy control participants, according to a study published online in the...
Whether on watch-and-wait or treatment regimens, patients with chronic lymphocytic leukemia had significantly impaired quality of life compared with age-matched healthy control participants, according to a study published online in the...
Whether on watch-and-wait or...
09/25/2020
First Report Managed Care
News Connection
Over $1.4 Billion Wasted on Discarded Cancer Drugs According to Medicare Advantage, CMS Data
09/25/2020
According to a recent data analysis by the Centers for Medicare & Medicaid Services (CMS) and Medicare Advantage, more than $1.4 billion was wasted on discarded units of chemotherapy and other cancer-treating drugs in 2017 and 2018.
According to a recent data analysis by the Centers for Medicare & Medicaid Services (CMS) and Medicare Advantage, more than $1.4 billion was wasted on discarded units of chemotherapy and other cancer-treating drugs in 2017 and 2018.
According to a recent data...
09/25/2020
First Report Managed Care
News Connection
CMS Launches Digital Medicare Platform, Streamlines Resources
09/25/2020
Care Compare, a redesign of eight existing health care tools and platforms, was launched by the Centers of Medicare & Medicaid Services (CMS) recently in an effort to improve patient access to information and streamline health care service...
Care Compare, a redesign of eight existing health care tools and platforms, was launched by the Centers of Medicare & Medicaid Services (CMS) recently in an effort to improve patient access to information and streamline health care service...
Care Compare, a redesign of...
09/25/2020
First Report Managed Care
Integrated Healthcare Executive
Benefits of New Cloud-Based Program for Health Plans
09/25/2020
Julie Gould
Eric Sullivan, senior vice president of innovation and data strategies, Inovalon, discusses the Consumer Health Gateway, a new portal that allows health plans to build their own Patient Access API to comply with the new requirement of the...
Eric Sullivan, senior vice president of innovation and data strategies, Inovalon, discusses the Consumer Health Gateway, a new portal that allows health plans to build their own Patient Access API to comply with the new requirement of the...
Eric Sullivan, senior vice...
09/25/2020
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
Long-Wave Infrared Thermography Helps LTACH Achieve Pressure Injury Success
04/25/2023
Jolynn Tumolo
“The LTACH facility maintained a zero hospital-acquired pressure injury rate for 10 months after implementation of long-wave infrared thermography," researchers reported.
“The LTACH facility maintained a zero hospital-acquired pressure injury rate for 10 months after implementation of long-wave infrared thermography," researchers reported.
“The LTACH facility maintained a...
04/25/2023
First Report Managed Care
Headshot of Barbara Konkle, MD, on a blue background underneath the PopHealth Perspectives logo.
Podcasts
Discussing a Novel Factor VIII Replacement Therapy for Patients With Hemophilia
05/24/2023
Maria Asimopoulos
Barbara Konkle, MD, professor of medicine, Division of Hematology, University of Washington; research director, Washington Center for Bleeding Disorders; and director, Hemostasis, Platelet Immunology and Genomics Laboratory at Bloodworks...
Barbara Konkle, MD, professor of medicine, Division of Hematology, University of Washington; research director, Washington Center for Bleeding Disorders; and director, Hemostasis, Platelet Immunology and Genomics Laboratory at Bloodworks...
Barbara Konkle, MD, professor of...
05/24/2023
First Report Managed Care
Formulary Frontlines®
Challenges, Treatment Options, and Costs Linked With Upper Tract Urothelial Carcinoma
06/20/2023
Julie Gould
Bladder cancer was the sixth most common cancer type in the United States in 2020, behind breast, lung, prostate, colon, and skin cancers.
Bladder cancer was the sixth most common cancer type in the United States in 2020, behind breast, lung, prostate, colon, and skin cancers.
Bladder cancer was the sixth...
06/20/2023
First Report Managed Care
News
Medicare Could Save $1 Billion by Considering Added Benefit of Expensive Part B Drugs
07/18/2023
Jolynn Tumolo
Researchers find that Medicare could potentially save $1 billion by considering the added therapeutic benefit of expensive Part B drugs and implementing reference pricing.
Researchers find that Medicare could potentially save $1 billion by considering the added therapeutic benefit of expensive Part B drugs and implementing reference pricing.
Researchers find that Medicare...
07/18/2023
First Report Managed Care
News
New Platform Leverages Real-World Evidence for Type 2 Inflammation Immunological Disease Research
08/07/2023
Hannah Musick
Researchers introduce Immunolab, a platform that generates real-world evidence to provide insights and conduct research on immunological diseases related to type 2 inflammation.
Researchers introduce Immunolab, a platform that generates real-world evidence to provide insights and conduct research on immunological diseases related to type 2 inflammation.
Researchers introduce Immunolab,...
08/07/2023
First Report Managed Care

September 2020 Volume 17 Issue 8

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