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Feature Story
Medical Cost Increases Projected for 2024
03/01/2024
PwC's Health Research Institute surveyed health plan actuaries covering nearly 100 million employer-sponsored and 10 million Affordable Care Act marketplace members to project medical cost trends for 2023-2024, highlighting factors like...
PwC's Health Research Institute surveyed health plan actuaries covering nearly 100 million employer-sponsored and 10 million Affordable Care Act marketplace members to project medical cost trends for 2023-2024, highlighting factors like...
PwC's Health Research Institute...
03/01/2024
First Report Managed Care
Feature Story
Payers Bet Big on Home Health Care
06/20/2023
Large health insurers are making multibillion-dollar deals to acquire home health care providers. Here’s why.
Large health insurers are making multibillion-dollar deals to acquire home health care providers. Here’s why.
Large health insurers are making...
06/20/2023
First Report Managed Care
Feature Story
The Coming Obesity Rx Cost Crisis
08/12/2021
New treatments have been approved by the US Food & Drug Administration (FDA) for the treatment of obesity but payers covering these patient populations must now determine how to provide coverage and that begins with understanding the latest...
New treatments have been approved by the US Food & Drug Administration (FDA) for the treatment of obesity but payers covering these patient populations must now determine how to provide coverage and that begins with understanding the latest...
New treatments have been...
08/12/2021
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
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
States Consider Banning Hospital Fees for Telehealth, Clinic Visits
04/05/2023
Lawmakers in Colorado are considering a bill to prohibit facility fees for services such as telehealth appointments and primary care visits, which some hospital executives say could disrupt patient access to care.
Lawmakers in Colorado are considering a bill to prohibit facility fees for services such as telehealth appointments and primary care visits, which some hospital executives say could disrupt patient access to care.
Lawmakers in Colorado are...
04/05/2023
First Report Managed Care
News
Fewer Black Patients Prescribed Novel Agents for CLL in the VA System
04/24/2023
“Further studies should explore other socioeconomic and cultural factors that may drive these racial disparities, as well as the safety and effectiveness of treatments by race, to better understand how racial disparities might impact patient...
“Further studies should explore other socioeconomic and cultural factors that may drive these racial disparities, as well as the safety and effectiveness of treatments by race, to better understand how racial disparities might impact patient...
“Further studies should explore...
04/24/2023
First Report Managed Care
News
SDoH, Financial Hardship Exacerbate Distress in Individuals With Hemophilia
05/23/2023
Researchers examined the presence of hemophilia-related distress in adults to shed light on potential racial and ethnic differences, as well as income-based disparities.
Researchers examined the presence of hemophilia-related distress in adults to shed light on potential racial and ethnic differences, as well as income-based disparities.
Researchers examined the...
05/23/2023
First Report Managed Care
Poll
Preparing for PDT Coverage
06/15/2023
To learn more about PDT coverage through exclusive industry leader insight into PDT market access, evaluation, and delivery, visit the excellence forum.  To read more on payer trends in contracting and disease management, click here.
To learn more about PDT coverage through exclusive industry leader insight into PDT market access, evaluation, and delivery, visit the excellence forum.  To read more on payer trends in contracting and disease management, click here.
To learn more about PDT coverage...
06/15/2023
First Report Managed Care
News
Epcoritamab Shows Durable Response in Relapsed/Refractory Large B-Cell Lymphoma
07/14/2023
“The observed high response rates with durability in patients with refractory large B-cell lymphoma treated with epcoritamab, including postchimeric antigen receptor-T therapy, represent further evidence of the value of bispecific antibodies...
“The observed high response rates with durability in patients with refractory large B-cell lymphoma treated with epcoritamab, including postchimeric antigen receptor-T therapy, represent further evidence of the value of bispecific antibodies...
“The observed high response...
07/14/2023
First Report Managed Care

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