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Balancing Medicare Advantage Denials for Patients With Diabetic Macular Edema
03/04/2024

Emry Lloyd

Emry Lloyd
Every year, millions of necessary medical service claims are denied by health care providers; policymakers want to balance these denials for those who need care and how this affects patients with diabetic macular edema.
Every year, millions of necessary medical service claims are denied by health care providers; policymakers want to balance these denials for those who need care and how this affects patients with diabetic macular edema.
Every year, millions of...
03/04/2024
First Report Managed Care
News
Retrospective Study Shows Potential of Dexamethasone Implant for Treatment-Resistant Diabetic Macular Edema
02/01/2024
Hannah Musick
“The study’s findings provide insights into improving visual acuity and reducing macular thickness, along with manageable IOP changes,” said researchers. “This personalized approach is a valuable addition to DME management, especially for...
“The study’s findings provide insights into improving visual acuity and reducing macular thickness, along with manageable IOP changes,” said researchers. “This personalized approach is a valuable addition to DME management, especially for...
“The study’s findings provide...
02/01/2024
First Report Managed Care
News
Subthreshold Micropulse Laser Equivalent to Standard Laser Therapy for DME
01/10/2024
Jolynn Tumolo
Subthreshold micropulse laser therapy was comparable in both efficacy and cost to standard laser therapy in patients with diabetic macular edema (DME) with central retinal thickness less than 400 μm, according to a noninferiority trial...
Subthreshold micropulse laser therapy was comparable in both efficacy and cost to standard laser therapy in patients with diabetic macular edema (DME) with central retinal thickness less than 400 μm, according to a noninferiority trial...
Subthreshold micropulse laser...
01/10/2024
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News
Response to First Anti-VEGF Injection for DME Predicts Long-term Effects of Therapy
11/21/2022
Jolynn Tumolo
To understand whether initial outcomes were a predictor of long-term results, study authors followed patients with diabetic macular edema for several months to assess their responses to anti-vascular endothelial growth factor injections.
To understand whether initial outcomes were a predictor of long-term results, study authors followed patients with diabetic macular edema for several months to assess their responses to anti-vascular endothelial growth factor injections.
To understand whether initial...
11/21/2022
First Report Managed Care
News
Retinal Thickness Lower With Intravitreal Steroids for Diabetic Macular Edema
11/09/2022
Jolynn Tumolo
“Our results reinforce the importance of a continual reevaluation of the role of intravitreal steroids in diabetic macular edema management,” wrote study authors.
“Our results reinforce the importance of a continual reevaluation of the role of intravitreal steroids in diabetic macular edema management,” wrote study authors.
“Our results reinforce the...
11/09/2022
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News
Treatment More Effective Than Laser Photocoagulation for Improving Diabetic Macular Edema
10/24/2022
Jolynn Tumolo
Findings showed targeted therapy improved visual and anatomical outcomes in patients with diabetic macular edema.
Findings showed targeted therapy improved visual and anatomical outcomes in patients with diabetic macular edema.
Findings showed targeted therapy...
10/24/2022
First Report Managed Care
News
Anti-VEGF Treatment Changes Aqueous Cytokine Levels in Patients With DME
10/21/2022
Edan Stanley
Researchers examined the alterations of different aqueous humor cytokine concentrations after intravitreal antivascular endothelial growth factor treatment in patients with diabetic macular edema.
Researchers examined the alterations of different aqueous humor cytokine concentrations after intravitreal antivascular endothelial growth factor treatment in patients with diabetic macular edema.
Researchers examined the...
10/21/2022
First Report Managed Care
News
Cataract Surgery Outcomes Unaffected by Intravitreal Aflibercept for Diabetic Macular Edema
09/21/2022
Jolynn Tumolo
Intravitreal aflibercept, gender, and other factors "did not interfere with the morphological and functional outcomes of diabetic macular edema in cataract surgery,” researchers said.
Intravitreal aflibercept, gender, and other factors "did not interfere with the morphological and functional outcomes of diabetic macular edema in cataract surgery,” researchers said.
Intravitreal aflibercept,...
09/21/2022
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News
Intravitreal VEGF Inhibitors Associated With HbA1c Reduction for Patients With DME
09/14/2022
Maria Asimopoulos
Recent findings show the impact of intravitreal aflibercept and ranibizumab on estimated glomerular filtration rates and glycated hemoglobin A1c for patients with diabetic macular edema.
Recent findings show the impact of intravitreal aflibercept and ranibizumab on estimated glomerular filtration rates and glycated hemoglobin A1c for patients with diabetic macular edema.
Recent findings show the impact...
09/14/2022
First Report Managed Care
News
Preoperative Bevacizumab Benefits Patients With Diabetes With Vitreous Hemorrhage Without Tractional Detachment
06/02/2022
Jolynn Tumolo
Patients had a lower likelihood of developing diabetic macular edema after receiving preoperative bevacizumab.
Patients had a lower likelihood of developing diabetic macular edema after receiving preoperative bevacizumab.
Patients had a lower likelihood...
06/02/2022
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
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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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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
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Headshot of Barbara Konkle, MD, on a blue background underneath the PopHealth Perspectives logo.
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05/24/2023
Maria Asimopoulos
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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
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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
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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

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