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January/February/March Volume 22, Issue 1, First Report Managed Care

Featured Article

Regulatory Insights
Making Sense of the Federal Budget Process for Managed Care
02/27/2025
The Inflation Reduction Act (IRA) of 2022 was passed as a reconciliation bill. This year, we may have two or more overlapping budget bills. They’re likely to contain some of the most significant legislation of 2025. But how are they...
The Inflation Reduction Act (IRA) of 2022 was passed as a reconciliation bill. This year, we may have two or more overlapping budget bills. They’re likely to contain some of the most significant legislation of 2025. But how are they...
The Inflation Reduction Act...
02/27/2025
First Report Managed Care

Department

Managed Care Q&A
2025 Drugs to Watch: Market Access, Innovation, and the Future of Reimbursement
02/28/2025
In this interview, guest experts John Stahl and Roy Moore explore the evolving payer landscape in 2025, discussing the growing role of value-based agreements, real-world evidence, and innovative reimbursement models in supporting the adoption...
In this interview, guest experts John Stahl and Roy Moore explore the evolving payer landscape in 2025, discussing the growing role of value-based agreements, real-world evidence, and innovative reimbursement models in supporting the adoption...
In this interview, guest experts...
02/28/2025
First Report Managed Care
Managed Care Q&A
The Future of Remote Patient Monitoring: Overcoming Challenges and Embracing Personalized Care
02/28/2025
A guest expert discusses the role of technology in shifting to proactive health care, emphasizing the relationship between data, AI, and personalized care in improving outcomes and reducing costs.
A guest expert discusses the role of technology in shifting to proactive health care, emphasizing the relationship between data, AI, and personalized care in improving outcomes and reducing costs.
A guest expert discusses the...
02/28/2025
First Report Managed Care
Behind the Bill
From Investigation to Legislation: The Growing Momentum for PBM Reform
02/27/2025
As the 119th Congress settles in alongside the incoming Trump administration, pharmacy benefit managers (PBMs) face unprecedented scrutiny from multiple directions.
As the 119th Congress settles in alongside the incoming Trump administration, pharmacy benefit managers (PBMs) face unprecedented scrutiny from multiple directions.
As the 119th Congress settles in...
02/27/2025
First Report Managed Care

Feature

Feature Story
Enhancing Program Administration in Health Care
02/19/2025
Guest experts share the need for health care organizations to focus on effective program administration to succeed in value-based care models, utilizing artificial intelligence (AI) and data-driven decision-making to optimize care delivery...
Guest experts share the need for health care organizations to focus on effective program administration to succeed in value-based care models, utilizing artificial intelligence (AI) and data-driven decision-making to optimize care delivery...
Guest experts share the need for...
02/19/2025
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
Special Medicaid Funds Help Most States, but Prompt Oversight Concerns
04/10/2023
A proposed state funding initiative in Georgia could significantly reduce financial losses suffered by rural hospitals, but patient advocates argue adoption of Medicaid expansion is more urgent.
A proposed state funding initiative in Georgia could significantly reduce financial losses suffered by rural hospitals, but patient advocates argue adoption of Medicaid expansion is more urgent.
A proposed state funding...
04/10/2023
First Report Managed Care
News
Patients With Thin-Liquid Dysphagia Benefit From Free Water Protocol at LTACH
04/25/2023
A free water protocol implemented at a long-term acute care hospital improved patients' hydration and quality of life without resulting in aspiration pneumonia, findings show.
A free water protocol implemented at a long-term acute care hospital improved patients' hydration and quality of life without resulting in aspiration pneumonia, findings show.
A free water protocol...
04/25/2023
First Report Managed Care
News
DMT Switching Associated With Lower Adherence, Persistence Among Patients With MS
05/24/2023
The findings indicate there "may be an opportunity for added care coordination or resources to optimize therapy transitions" for patients with multiple sclerosis, according to the researchers.
The findings indicate there "may be an opportunity for added care coordination or resources to optimize therapy transitions" for patients with multiple sclerosis, according to the researchers.
The findings indicate there "may...
05/24/2023
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
News
Disparities Between Guideline Recommendations, Implementation of Pharmacokinetic Dosing for Bleeding Disorders
07/17/2023
Authors of a recent scoping review explored trends in the efficacy and feasibility of implementing pharmacokinetic-guided dosing in clinical practice for patients with bleeding disorders.
Authors of a recent scoping review explored trends in the efficacy and feasibility of implementing pharmacokinetic-guided dosing in clinical practice for patients with bleeding disorders.
Authors of a recent scoping...
07/17/2023
First Report Managed Care

March 2025 Volume 22 Issue 1

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