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Commentary
Navigating the Decline of Medicare Advantage Star Ratings in 2025: Six Need-to-Knows
11/25/2024
Cindy Henry
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
Shannon Smith, RN, BSN
Commentary
Navigating the CY 2025 CMS Physician Fee Schedule Proposals: Strategic Insights for Health Care Leaders
09/30/2024
Shannon Smith, RN, BSN
The Centers for Medicare & Medicaid Services (CMS) has released its calendar year (CY) 2025 physician fee schedule proposals. In this commentary, an expert breaks down the key components and their implications for health care organizations.
The Centers for Medicare & Medicaid Services (CMS) has released its calendar year (CY) 2025 physician fee schedule proposals. In this commentary, an expert breaks down the key components and their implications for health care organizations.
The Centers for Medicare &...
09/30/2024
First Report Managed Care
Commentary
Payer-Provider Synergy: Aligning at the Fulcrum Points
08/05/2024
Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...
Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...
Payer-provider collaboration...
08/05/2024
First Report Managed Care
Christie Headshot
Commentary
How Medicare Advantage Plans Can Prepare for the CMS Health Equity Index
02/13/2024
Christie Teigland, PhD
As part of the 2024 Medicare Advantage (MA) and Part D Final Rule, CMS is enhancing the Star Ratings program by implementing a Health Equity Index (HEI) reward to incentivize MA and Part D contracts with 500 or more members to address...
As part of the 2024 Medicare Advantage (MA) and Part D Final Rule, CMS is enhancing the Star Ratings program by implementing a Health Equity Index (HEI) reward to incentivize MA and Part D contracts with 500 or more members to address...
As part of the 2024 Medicare...
02/13/2024
First Report Managed Care
Ashley Headshot
Commentary
2025–2026 Star Ratings: The Path to Success
01/09/2024
Ashley McNairy
Even though many Medicare Advantage (MA) health plan executives braced for another year of declining performance on their Star Ratings, seeing their 2024 ratings drop for the second consecutive year has been a tough pill to swallow. Ashley...
Even though many Medicare Advantage (MA) health plan executives braced for another year of declining performance on their Star Ratings, seeing their 2024 ratings drop for the second consecutive year has been a tough pill to swallow. Ashley...
Even though many Medicare...
01/09/2024
First Report Managed Care
Anup Headshot
Commentary
Simple Outreach Tactics Plug Medicaid Redetermination Gaps
12/21/2023
Anup Panthaloor
The unwinding of Medicaid’s continuous enrollment and resulting redetermination activities were supposed to be nearly complete by spring 2024. According to Anup Panthaloor, Firstsource EVP, now, the initiative may be pushed into the summer of...
The unwinding of Medicaid’s continuous enrollment and resulting redetermination activities were supposed to be nearly complete by spring 2024. According to Anup Panthaloor, Firstsource EVP, now, the initiative may be pushed into the summer of...
The unwinding of Medicaid’s...
12/21/2023
First Report Managed Care
Icario logo.
Commentary
Eight Surprising Medicaid Health Risk Assessment Mistakes
03/15/2023
The Icario team shares 8 mistakes Medicaid plans may be making when reaching out to members to complete their health risk assessments, as well as best practices to improve the process.
The Icario team shares 8 mistakes Medicaid plans may be making when reaching out to members to complete their health risk assessments, as well as best practices to improve the process.
The Icario team shares 8...
03/15/2023
First Report Managed Care
Icario logo.
Commentary
Top 5 Medicaid Redetermination Questions Answered
03/01/2023
In this commentary, the Icario team addresses 5 concerns health plans may have as pandemic-era Medicaid provisions expire, including dates to remember, best practices for reaching members, and more.
In this commentary, the Icario team addresses 5 concerns health plans may have as pandemic-era Medicaid provisions expire, including dates to remember, best practices for reaching members, and more.
In this commentary, the Icario...
03/01/2023
First Report Managed Care
Icario logo.
Commentary
Five Winning Strategies to Boost Member Experience, Improve CAHPS Scores
01/18/2023
The Icario team reviews 5 strategies for boosting CAHPS scores and Star Ratings, with an emphasis on personalized member experiences, appropriate language, and outreach methods.
The Icario team reviews 5 strategies for boosting CAHPS scores and Star Ratings, with an emphasis on personalized member experiences, appropriate language, and outreach methods.
The Icario team reviews 5...
01/18/2023
First Report Managed Care
Icario logo.
Commentary
Three Ways to Improve Member Experience Using Language
10/07/2022
The Icario team shares 3 strategies for improving communication with members, which has the potential to reduce churn and raise Star Ratings.
The Icario team shares 3 strategies for improving communication with members, which has the potential to reduce churn and raise Star Ratings.
The Icario team shares 3...
10/07/2022
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
First Report Managed Care
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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Trending Articles

Elizabeth Brem University of California Irvine
Videos
Analyzing Patient Selection and the Utility of CNS Prophylaxis for Patients With DLBCL
04/20/2023
In a debate at the 2023 Great Debates & Updates in Hematologic Malignancies conference in New York, New York, Elizabeth A. Brem, MD, analyzed the role of central nervous system prophylaxis for patients with DLBCL.
In a debate at the 2023 Great Debates & Updates in Hematologic Malignancies conference in New York, New York, Elizabeth A. Brem, MD, analyzed the role of central nervous system prophylaxis for patients with DLBCL.
In a debate at the 2023 Great...
04/20/2023
Oncology
News
Thousands Face Medicaid Coverage Disruptions in South Dakota and North Carolina
05/18/2023
Arielle Zionts
Now that the public health emergency has expired, individuals may lose coverage but then requalify several months later in states which have recently approved Medicaid expansion.
Now that the public health emergency has expired, individuals may lose coverage but then requalify several months later in states which have recently approved Medicaid expansion.
Now that the public health...
05/18/2023
First Report Managed Care
News
Digital Therapeutics "Viable Solution" for Mental Health Needs
06/07/2023
Jolynn Tumolo
“The participants were willing to utilize digital therapeutics if available, and even preferred this type of support compared to actually visiting a clinic,” researchers wrote.
“The participants were willing to utilize digital therapeutics if available, and even preferred this type of support compared to actually visiting a clinic,” researchers wrote.
“The participants were willing...
06/07/2023
First Report Managed Care
News
First Gene Therapy for Severe Hemophilia A Is Approved
06/29/2023
Amanda Balbi
This approval comes after a safety and effectiveness trial showed that the treatment improved participants’ annualized bleeding rate after 3 years.
This approval comes after a safety and effectiveness trial showed that the treatment improved participants’ annualized bleeding rate after 3 years.
This approval comes after a...
06/29/2023
First Report Managed Care
Stock image of a doctor holding a phone
Commentary
Prescription Digital Therapeutics: Ongoing Efforts to Expand Awareness, Integrate Into Clinical Practice
07/28/2023
Yvette C. Terrie, BS Pharm, RPh
Yvette Terrie shares digital therapeutic updates regarding FDA approvals, recent and upcoming clinical trials, and current industry regulations.
Yvette Terrie shares digital therapeutic updates regarding FDA approvals, recent and upcoming clinical trials, and current industry regulations.
Yvette Terrie shares digital...
07/28/2023
First Report Managed Care

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