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Poll
Adapting Medicare Advantage Plans to Star Ratings in 2025
01/10/2025
With Medicare Advantage under increased scrutiny and Star Ratings impacting payments, how do you think plans will adapt in 2025?
With Medicare Advantage under increased scrutiny and Star Ratings impacting payments, how do you think plans will adapt in 2025?
With Medicare Advantage under...
01/10/2025
First Report Managed Care
News
Study Suggests Innovative Value-Based Models for Expanding Cell and Gene Therapy Access
12/17/2024
Juliet Gallagher
Cell and gene therapies (CGTs) offer groundbreaking approaches for treating rare and complex conditions. However, the high costs of CGTs create barriers to equitable access and affordability. A study published in Journal of Medical Economics...
Cell and gene therapies (CGTs) offer groundbreaking approaches for treating rare and complex conditions. However, the high costs of CGTs create barriers to equitable access and affordability. A study published in Journal of Medical Economics...
Cell and gene therapies (CGTs)...
12/17/2024
First Report Managed Care
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
Conference Coverage
New Medicare Part D Out-of-Pocket Maximum Poses Barrier to Accessing Expensive Alzheimer Treatments
10/16/2024
Hannah Musick
A study presented at AMCP Nexus 2024 reveals that most patients with Alzheimer disease are not expected to reach the new Medicare Part D out-of-pocket maximum of $2000, potentially hindering access to high-cost treatments like lecanemab.
A study presented at AMCP Nexus 2024 reveals that most patients with Alzheimer disease are not expected to reach the new Medicare Part D out-of-pocket maximum of $2000, potentially hindering access to high-cost treatments like lecanemab.
A study presented at AMCP Nexus...
10/16/2024
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
Managed Care Q&A
Insights and Strategies for Success for 2025 Medicare Advantage Open Enrollment
08/29/2024
Jordan Armstrong
Learn about key factors influencing the 2025 Medicare Advantage open enrollment period including payment rate adjustments, compliance regulations, behavioral health benefits, and the importance of hyper-personalization for enhancing customer...
Learn about key factors influencing the 2025 Medicare Advantage open enrollment period including payment rate adjustments, compliance regulations, behavioral health benefits, and the importance of hyper-personalization for enhancing customer...
Learn about key factors...
08/29/2024
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
Blog
Medicare Prescription Payment Plan: What Health Plans Need to Know
07/29/2024
Katie Hayes, MJ
The Centers for Medicare and Medicaid Services recently released final part two guidance on the Medicare Prescription Payment Plan (M3P), formerly known as "smoothing."
The Centers for Medicare and Medicaid Services recently released final part two guidance on the Medicare Prescription Payment Plan (M3P), formerly known as "smoothing."
The Centers for Medicare and...
07/29/2024
First Report Managed Care
Brian Esterly Headshot
Interview
Insights on the 2024 Medicare Physician Fee Schedule: Implications and Opportunities for Virtual Care Management Services
07/26/2024
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician...
07/26/2024
First Report Managed Care
Blog
Why We’re Already Thinking Ahead to 2028 Part B Drug Price Negotiations
07/18/2024
Katie Hayes, MJ
Learn why industry stakeholders should prepare for 2028 negotiations now to ensure long-term financial stability and regulatory compliance.
Learn why industry stakeholders should prepare for 2028 negotiations now to ensure long-term financial stability and regulatory compliance.
Learn why industry stakeholders...
07/18/2024
First Report Managed Care
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