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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
Dean Celia
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
Mary Beth Nierengarten
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
Edan Stanley
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
Steve Wigginton
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
Robin Figueroa
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

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

Headshot of Gary Owens
Interview
An Overview of Vitiligo: Prevalence, Comorbidities, and Available Therapies
05/30/2023
Maria Asimopoulos
Gary Owens, MD, president of Gary Owens Associates, reviews the prevalence and burden associated with vitiligo as well as coverage considerations for a range of treatment options. 
Gary Owens, MD, president of Gary Owens Associates, reviews the prevalence and burden associated with vitiligo as well as coverage considerations for a range of treatment options. 
Gary Owens, MD, president of...
05/30/2023
First Report Managed Care
News
Substantial Annual Health Care Costs Associated With Hemophilia A
06/23/2023
Julie Gould
Researchers conducted a comprehensive literature review to investigate the direct and indirect costs associated with hemophilia A.
Researchers conducted a comprehensive literature review to investigate the direct and indirect costs associated with hemophilia A.
Researchers conducted a...
06/23/2023
First Report Managed Care
News
RSV Vaccination in US Older Adults Could Save Up to $1 Billion Per Season
07/24/2023
Jolynn Tumolo
"Our analysis provides contemporary estimates of the population-level RSV disease burden and insights into the economic value drivers for RSV vaccination," said researchers. 
"Our analysis provides contemporary estimates of the population-level RSV disease burden and insights into the economic value drivers for RSV vaccination," said researchers. 
"Our analysis provides...
07/24/2023
First Report Managed Care
News
Hospital-Onset CDI Incidence, Antibiotic Use Drop With Two-Step Testing
08/16/2023
Jolynn Tumolo
The implementation of two-step testing for Clostridioides difficile infection may lead to a decrease in hospital-onset CDI and antibiotic use, suggesting improved diagnostic specificity and indirect reassurance against underdiagnosis and...
The implementation of two-step testing for Clostridioides difficile infection may lead to a decrease in hospital-onset CDI and antibiotic use, suggesting improved diagnostic specificity and indirect reassurance against underdiagnosis and...
The implementation of two-step...
08/16/2023
First Report Managed Care

February 2021 Volume 18 Issue 1

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