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Cover Story
What’s Next for Health Care Policy in the US?
11/25/2024
With new faces and shifting power dynamics in Washington, concerns about health care policy in 2025 are rising, including potential reform of PBMs, the 340B program, and the IRA, as well as the push for expanded access to innovative therapies...
With new faces and shifting power dynamics in Washington, concerns about health care policy in 2025 are rising, including potential reform of PBMs, the 340B program, and the IRA, as well as the push for expanded access to innovative therapies...
With new faces and shifting...
11/25/2024
First Report Managed Care

Feature

Feature Story
Prior Authorization in 2025: Key Trends Shaping the Future of Health Care
11/27/2024
In 2025, prior authorization undergoes a transformative evolution driven by regulatory changes, artificial intelligence enhancements, proactive utilization forecasting, and the integration of clinical nudges, all aimed at improving care...
In 2025, prior authorization undergoes a transformative evolution driven by regulatory changes, artificial intelligence enhancements, proactive utilization forecasting, and the integration of clinical nudges, all aimed at improving care...
In 2025, prior authorization...
11/27/2024
First Report Managed Care

Department

Managed Care Q&A
Addressing the Shortage of Mental Health Professionals in Primary Care
11/27/2024
In this interview, Julie Frey of Wolters Kluwer Health discusses the importance of integrating mental health into primary care, the barriers faced by providers, the long-term costs of untreated mental health conditions, and successful...
In this interview, Julie Frey of Wolters Kluwer Health discusses the importance of integrating mental health into primary care, the barriers faced by providers, the long-term costs of untreated mental health conditions, and successful...
In this interview, Julie Frey of...
11/27/2024
First Report Managed Care
Managed Care Q&A
Improving Mental Health Care for Women in Underserved Communities
11/26/2024
In an interview with guest expert Sipra Laddha, MD, she discusses the pressing issues facing women's mental health during pregnancy and postpartum, highlighting the lack of resources and the need for enhanced screening by OB-GYNs to support...
In an interview with guest expert Sipra Laddha, MD, she discusses the pressing issues facing women's mental health during pregnancy and postpartum, highlighting the lack of resources and the need for enhanced screening by OB-GYNs to support...
In an interview with guest...
11/26/2024
First Report Managed Care

Insights

Commentary
Navigating the Decline of Medicare Advantage Star Ratings in 2025: Six Need-to-Knows
11/25/2024
The 2025 Medicare Advantage Star Ratings present a new landscape for MA plans, with fewer achieving high ratings due to changes in methodology, utilization patterns, ongoing litigation, and potential impacts of recent election outcomes. Learn...
The 2025 Medicare Advantage Star Ratings present a new landscape for MA plans, with fewer achieving high ratings due to changes in methodology, utilization patterns, ongoing litigation, and potential impacts of recent election outcomes. Learn...
The 2025 Medicare Advantage Star...
11/25/2024
First Report Managed Care
Image, Teaser, Author, Subhead
FRMC Volume 21, Issue 4

Current Issue

October/November/December Volume 21, Issue 4, First Report Managed Care
Current Issue
Issue Archive

What's Trending?

News
FDA Decision on Highly Anticipated DMD Drug Delayed
05/27/2016
The U.S. Food and Drug Administration deferred a highly anticipated decision on whether to approve Sarepta Therapeutics Inc's muscle-wasting disorder drug, a month after an advisory panel determined that the treatment was not effective.
The U.S. Food and Drug Administration deferred a highly anticipated decision on whether to approve Sarepta Therapeutics Inc's muscle-wasting disorder drug, a month after an advisory panel determined that the treatment was not effective.
The U.S. Food and Drug...
05/27/2016
First Report Managed Care
News
More Medicare Beneficiaries Switching to Medicare Advantage
01/23/2023
Using data from the Centers for Medicare & Medicaid Services, researchers examined trends in the number of beneficiaries switching between Medicare and Medicare Advantage plans from 2014 to 2020.
Using data from the Centers for Medicare & Medicaid Services, researchers examined trends in the number of beneficiaries switching between Medicare and Medicare Advantage plans from 2014 to 2020.
Using data from the Centers for...
01/23/2023
First Report Managed Care
Prevention of COPD with Tiotropium or Salmeterol
08/23/2011
Patients with exacerbations of chronic obstructive pulmonary disease (COPD) may be experiencing instability or worsening of their disease. Worldwide, COPD is the leading cause of disability and death, and exacerbations have been associated...
Patients with exacerbations of chronic obstructive pulmonary disease (COPD) may be experiencing instability or worsening of their disease. Worldwide, COPD is the leading cause of disability and death, and exacerbations have been associated...
Patients with exacerbations of...
08/23/2011
First Report Managed Care
News
California lawsuit accuses Bristol-Myers Squibb of fraud, kickbacks
03/28/2011
03/28/2011
First Report Managed Care
News
Checks In The Mail: Millions Expected To Receive Insurance Rebates Totaling $1.3 Billion
04/26/2012
04/26/2012
First Report Managed Care

Video Insights

Formoso Headshot
Videos
Minimally Invasive Solutions for Lumbar Disc Herniation
01/07/2025
In this interview, Ferdinand Formoso, DO, discusses the role of condoliase as a minimally invasive treatment for lumbar disc herniation, its safety profile, potential areas for further research, and its ability to address unmet needs in spine...
In this interview, Ferdinand Formoso, DO, discusses the role of condoliase as a minimally invasive treatment for lumbar disc herniation, its safety profile, potential areas for further research, and its ability to address unmet needs in spine...
In this interview, Ferdinand...
01/07/2025
First Report Managed Care
Kolodziej Headshot
Videos
Navigating Biosimilar Adoption: Lessons from Global Markets and Clinical Practices
12/20/2024
In this interview, Michael Kolodziej, MD, discusses strategies for enhancing biosimilar adoption in the US, emphasizing lessons from global markets, the importance of payer flexibility, and the need for collaboration to reduce costs and...
In this interview, Michael Kolodziej, MD, discusses strategies for enhancing biosimilar adoption in the US, emphasizing lessons from global markets, the importance of payer flexibility, and the need for collaboration to reduce costs and...
In this interview, Michael...
12/20/2024
First Report Managed Care
Mike Kolodziej, MD
Videos
Exploring Biosimilar Adoption and Policy Impacts in Oncology
12/18/2024
In this interview, Michael Kolodziej, MD, discusses the role of biosimilars in value-based care models, their relationship with targeted therapies, and the impact of policy changes and market trends on biosimilar adoption and cost...
In this interview, Michael Kolodziej, MD, discusses the role of biosimilars in value-based care models, their relationship with targeted therapies, and the impact of policy changes and market trends on biosimilar adoption and cost...
In this interview, Michael...
12/18/2024
First Report Managed Care
Hennessy Headshot
Videos
Navigating Biosimilar Integration: Cost Savings, Coverage, and Future Strategies for Payers
12/10/2024
John Hennessy, MBA, discusses the complexities of biosimilar adoption, highlighting potential cost savings, payer strategies, challenges in provider and patient acceptance, regulatory impacts, and the critical need for sustainable market...
John Hennessy, MBA, discusses the complexities of biosimilar adoption, highlighting potential cost savings, payer strategies, challenges in provider and patient acceptance, regulatory impacts, and the critical need for sustainable market...
John Hennessy, MBA, discusses...
12/10/2024
First Report Managed Care
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

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