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Volume 18, Issue 1, January/February 2021 - First Report Managed Care

Featured Article

Cover Story
Online Crowdfunding for Health-Related Expenses Trends Upward
02/12/2021
What does this say about the affordability of health care, and are there solutions to minimize reliance on this ubiquitous tool?
What does this say about the affordability of health care, and are there solutions to minimize reliance on this ubiquitous tool?
What does this say about the...
02/12/2021
First Report Managed Care
Feature
Drug Repurposing: Expediting Discovery Through a Novel Algorithmic Framework
02/12/2021
As the COVID-19 pandemic continues to stretch the ability and capacity of health care systems—from curbing infection rates, treating severe illness, understanding new variants, to distributing and administering limited vaccine doses—gaps and...
As the COVID-19 pandemic continues to stretch the ability and capacity of health care systems—from curbing infection rates, treating severe illness, understanding new variants, to distributing and administering limited vaccine doses—gaps and...
As the COVID-19 pandemic...
02/12/2021
First Report Managed Care
Literature Review
Examining Lasmiditan for the Acute Treatment of Migraine Compared With Triptans
02/12/2021
Per the American Migraine foundation, oral and intranasal triptan therapy has proven consistently effective when used to treat migraine earlier in the attack; however, triptan therapy is not effective for all patients with migraine and cannot...
Per the American Migraine foundation, oral and intranasal triptan therapy has proven consistently effective when used to treat migraine earlier in the attack; however, triptan therapy is not effective for all patients with migraine and cannot...
Per the American Migraine...
02/12/2021
First Report Managed Care

Insights

Commentary
Four Health Care Predictions for 2021
02/12/2021
What should we expect in health care in 2021? Get a jump on the new year with these informed predictions for health plans and members based on what we learned in 2020. As we reflect on an eventful year nobody was expecting, and as we look...
What should we expect in health care in 2021? Get a jump on the new year with these informed predictions for health plans and members based on what we learned in 2020. As we reflect on an eventful year nobody was expecting, and as we look...
What should we expect in health...
02/12/2021
First Report Managed Care
Commentary
The Impact of the Supreme Court’s Pending ACA Decision on Health Plans
02/12/2021
On November 10, 2020, the Supreme Court of the United States heard arguments from both sides on California v Texas, which deals with the constitutionality of the 2010 Affordable Care Act (ACA) following the passage of the Tax Cuts and Jobs...
On November 10, 2020, the Supreme Court of the United States heard arguments from both sides on California v Texas, which deals with the constitutionality of the 2010 Affordable Care Act (ACA) following the passage of the Tax Cuts and Jobs...
On November 10, 2020, the...
02/12/2021
First Report Managed Care

Department

News Connection
Amazon Ends Joint Health Care Venture With Berkshire Hathaway, JP Morgan
02/12/2021
Amazon, Berkshire Hathaway, and JPMorgan Chase & Co, announced plans to dissolve their joint health care venture, Haven, a firm launched in January 2018, focused on finding solutions to a range of problematic health care trends.
Amazon, Berkshire Hathaway, and JPMorgan Chase & Co, announced plans to dissolve their joint health care venture, Haven, a firm launched in January 2018, focused on finding solutions to a range of problematic health care trends.
Amazon, Berkshire Hathaway, and...
02/12/2021
First Report Managed Care
News Connection
CMS, Part D Capping Out-of-Pocket Insulin Spend Could Improve Adherence
02/12/2021
The Centers for Medicare & Medicaid Services (CMS) recently launched the Senior Savings Model through Part D, which caps insulin out-of-pocket spend at no more than $35 per month for beneficiaries. Researchers of a recent JAMA Network Open...
The Centers for Medicare & Medicaid Services (CMS) recently launched the Senior Savings Model through Part D, which caps insulin out-of-pocket spend at no more than $35 per month for beneficiaries. Researchers of a recent JAMA Network Open...
The Centers for Medicare &...
02/12/2021
First Report Managed Care
News Connection
Medicare Advantage Plans See Enrollment Boosts During Pandemic
02/12/2021
Survey data collected by MedicareAdvantagePlans.org shows that Medicare Advantage (MA) plans are seeing increased enrollment amid the pandemic.
Survey data collected by MedicareAdvantagePlans.org shows that Medicare Advantage (MA) plans are seeing increased enrollment amid the pandemic.
Survey data collected by...
02/12/2021
First Report Managed Care
News Connection
Aetna, CVS Health Expand Transgender Surgery Coverage Offerings
02/12/2021
Aetna, a CVS Health company, announced recently that it is updating policies to expand coverage offerings of gender-affirming surgery to include breast augmentation for transfeminine beneficiaries.
Aetna, a CVS Health company, announced recently that it is updating policies to expand coverage offerings of gender-affirming surgery to include breast augmentation for transfeminine beneficiaries.
Aetna, a CVS Health company,...
02/12/2021
First Report Managed Care
News Connection
Lower Health Care Costs: Survey Shows Consumers Are Not Optimistic
02/12/2021
Prior to the inauguration of President Biden, West Health and Gallup conducted a survey to better understand how Americans feel about the state of health care and the new administration’s promises of reform, but results show that most...
Prior to the inauguration of President Biden, West Health and Gallup conducted a survey to better understand how Americans feel about the state of health care and the new administration’s promises of reform, but results show that most...
Prior to the inauguration of...
02/12/2021
First Report Managed Care
News Connection
ACA Fee Increase Effect on Primary Care Access for Dual-Eligible Beneficiaries
02/12/2021
In an effort to accommodate potential increases in demand for care under the Affordable Care Act (ACA), a fee bump was implemented in 2013 and 2014, increasing Medicaid payments to Medicare levels for certain services for primary care...
In an effort to accommodate potential increases in demand for care under the Affordable Care Act (ACA), a fee bump was implemented in 2013 and 2014, increasing Medicaid payments to Medicare levels for certain services for primary care...
In an effort to accommodate...
02/12/2021
First Report Managed Care
FRMC Volume 21, Issue 3

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September 2024
Volume 21
Issue 3
Current Issue
Issue Archive

What's Trending?

News
Roche gets Europe OK for new Herceptin formulation
09/03/2013
09/03/2013
First Report Managed Care
News
Trump Backs Negotiating Drug Prices Under Medicare: White House
02/08/2017
In a recent briefing, it was revealed that President Donald Trump has showed his support in favor of drug pricing negotiations. 
In a recent briefing, it was revealed that President Donald Trump has showed his support in favor of drug pricing negotiations. 
In a recent briefing, it was...
02/08/2017
First Report Managed Care
Headshot of Adam Kittai, Ohio State University, on a blue background underneath the PopHealth Perspectives logo.
Podcasts
CLL Research Update, Comparative Efficacy of Combination Treatments
12/14/2021
In part one of this podcast series, Adam Kittai, MD, hematologist and assistant professor of medicine, Ohio State University, provides an overview of current research being conducted on chronic lymphocytic leukemia and discusses the results...
In part one of this podcast series, Adam Kittai, MD, hematologist and assistant professor of medicine, Ohio State University, provides an overview of current research being conducted on chronic lymphocytic leukemia and discusses the results...
In part one of this podcast...
12/14/2021
First Report Managed Care
Preventable Hospital Readmissions among Medicare Beneficiaries
04/22/2013
Reducing preventable hospital readmissions is part of a federal strategy to create incentives to improve quality of care. In an effort to lower hospital readmission rates, the Centers for Medicare & Medicaid Services publicly reports...
Reducing preventable hospital readmissions is part of a federal strategy to create incentives to improve quality of care. In an effort to lower hospital readmission rates, the Centers for Medicare & Medicaid Services publicly reports...
Reducing preventable hospital...
04/22/2013
First Report Managed Care
News
State Efforts to Take Control of Medicaid Struggling
06/07/2011
06/07/2011
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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February 2021 Volume 18 Issue 1

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