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Commentary
How to Maximize the Value of GLP-1 Drugs While Improving Health Equity
01/14/2025
GLP-1 drugs present significant financial and health equity challenges, offering transformative benefits for obesity and cardiometabolic disorders while requiring data-driven strategies for cost-effective and equitable access.
GLP-1 drugs present significant financial and health equity challenges, offering transformative benefits for obesity and cardiometabolic disorders while requiring data-driven strategies for cost-effective and equitable access.
GLP-1 drugs present significant...
01/14/2025
First Report Managed Care
Hawley Headshot
Commentary
Beyond Medical Cost Savings: Optimizing Payment Integrity Value
10/31/2024
Health plan leaders increasingly recognize the value of utilizing technology as a counteroffensive against high medical loss ratios, which are now close to 90% in the large group market. As the industry is poised to face the same pressures in...
Health plan leaders increasingly recognize the value of utilizing technology as a counteroffensive against high medical loss ratios, which are now close to 90% in the large group market. As the industry is poised to face the same pressures in...
Health plan leaders increasingly...
10/31/2024
First Report Managed Care
Mike Spellman
Commentary
Unlocking Value in Payment Integrity: A New Paradigm for Health Insurers
10/01/2024
From cost-cutting to value creation, learn how payment integrity is shifting towards a more holistic approach in the health care industry to enhance care quality and stakeholder relationships.
From cost-cutting to value creation, learn how payment integrity is shifting towards a more holistic approach in the health care industry to enhance care quality and stakeholder relationships.
From cost-cutting to value...
10/01/2024
First Report Managed Care
Darland Headshot
Commentary
Expanding Access to Life-Saving Cardiac Care
07/01/2024
More than 6 million Americans are living with heart failure (HF), the leading cause of hospitalization among adults 65 and older. In this commentary, Chris Darland, CEO, Peerbridge Health, discusses emerging technologies, such as AI-enabled...
More than 6 million Americans are living with heart failure (HF), the leading cause of hospitalization among adults 65 and older. In this commentary, Chris Darland, CEO, Peerbridge Health, discusses emerging technologies, such as AI-enabled...
More than 6 million Americans...
07/01/2024
First Report Managed Care
Clay Ritchey Headshot
Commentary
Creating a Better Patient Experience Through Improved Identity Data Management
06/04/2024
Clay Ritchey, CEO, Verato
The ever evolving and pervasive digital ecosystem has transformed the way consumers research, engage, and transact—with more transparency and efficiency than ever before. And as health care digital transformation continues, consumers are...
The ever evolving and pervasive digital ecosystem has transformed the way consumers research, engage, and transact—with more transparency and efficiency than ever before. And as health care digital transformation continues, consumers are...
The ever evolving and pervasive...
06/04/2024
First Report Managed Care
Commentary
Next-Generation Utilization Management: Managing Utilization and Cost Without Denial of Service​​​
03/01/2024
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is...
03/01/2024
First Report Managed Care
Headshots of 14 leaders in health care
Commentary
2023 Predictions From Health Executives: Consumer Experience, Economic Considerations
01/10/2023
After a year of inflation, staffing struggles, and challenges related to addressing social determinants of health, 14 executives from health care organizations predict where the industry is headed in 2023.
After a year of inflation, staffing struggles, and challenges related to addressing social determinants of health, 14 executives from health care organizations predict where the industry is headed in 2023.
After a year of inflation,...
01/10/2023
Integrated Healthcare Executive
Icario logo.
Commentary
Three Insights From Trailblaze 2022: Member Experience Is About Humanization
08/19/2022
Icario Team
In this commentary, the Icario team shares advice on how to connect with members better, elevate their experience, and improve outcomes.
In this commentary, the Icario team shares advice on how to connect with members better, elevate their experience, and improve outcomes.
In this commentary, the Icario...
08/19/2022
First Report Managed Care
Headshots of Pavel Lavitas, PharmD, BCPS, and Amanda O'Hora
Commentary
Navigating Reimbursement and Access Challenges for Novel Cell and Gene Therapies
07/26/2022
In this commentary, Pavel Lavitas, PharmD, BCPS, and Amanda O'Hora review reimbursement and patient access challenges related to approved cell and gene-based therapies.
In this commentary, Pavel Lavitas, PharmD, BCPS, and Amanda O'Hora review reimbursement and patient access challenges related to approved cell and gene-based therapies.
In this commentary, Pavel...
07/26/2022
Pharmacy Learning Network
Icario logo.
Commentary
4 Tips to Avoid Member Abrasion in Health Care
06/30/2022
Icario Team
In this commentary, the Icario team provides tips for health plans to use data and appropriate communication strategies to keep members engaged.
In this commentary, the Icario team provides tips for health plans to use data and appropriate communication strategies to keep members engaged.
In this commentary, the Icario...
06/30/2022
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
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
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
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
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
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
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
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
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
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
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
Initiating Prophylaxis at Younger Age May Preserve Joint Status in Severe Hemophilia A
04/19/2023
Researchers found an association between long-term joint preservation status and patient age at the time of initiating primary prophylaxis for severe hemophilia A.
Researchers found an association between long-term joint preservation status and patient age at the time of initiating primary prophylaxis for severe hemophilia A.
Researchers found an association...
04/19/2023
First Report Managed Care
Icario logo.
Commentary
Advancing Health Equity With Personalized Member Experiences
05/16/2023
Icario Team
In this commentary, the Icario team explores the topic of advancing health equity and how recent updates to the CMS Framework for Health Equity can help health plans close gaps in care.
In this commentary, the Icario team explores the topic of advancing health equity and how recent updates to the CMS Framework for Health Equity can help health plans close gaps in care.
In this commentary, the Icario...
05/16/2023
First Report Managed Care
Conference Coverage
FDA Oncology Approvals Commonly Involve Surrogate Endpoints, Analysis Shows
06/02/2023
In an updated analysis presented at the 2023 ASCO Annual Meeting, researchers examined the frequency with which surrogate endpoints were used to support oncology approvals from 2006 to 2022.
In an updated analysis presented at the 2023 ASCO Annual Meeting, researchers examined the frequency with which surrogate endpoints were used to support oncology approvals from 2006 to 2022.
In an updated analysis presented...
06/02/2023
First Report Managed Care
Headshot of Anthony Watson on a blue background underneath the PopHealth Perspectives logo.
Podcasts
Payer Reimbursement and Prescription Digital Therapeutics: Understanding FDA Regulations
06/29/2023
Anthony Watson, former vice president of Regulatory and Quality at Pear Therapeutics, discusses his recent perspective article explaining FDA regulations as they relate to prescription digital therapeutics (PDTs) and highlights why he...
Anthony Watson, former vice president of Regulatory and Quality at Pear Therapeutics, discusses his recent perspective article explaining FDA regulations as they relate to prescription digital therapeutics (PDTs) and highlights why he...
Anthony Watson, former vice...
06/29/2023
First Report Managed Care
News
Fear of Movement in Patients With Ankylosing Spondylitis Linked With Lower Life Quality
07/27/2023
Research findings indicate a link between kinesiophobia, a fear of movement and injury, and decreased quality of life in patients with ankylosing spondylitis.
Research findings indicate a link between kinesiophobia, a fear of movement and injury, and decreased quality of life in patients with ankylosing spondylitis.
Research findings indicate a...
07/27/2023
First Report Managed Care

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