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News
Study Suggests Innovative Value-Based Models for Expanding Cell and Gene Therapy Access
12/17/2024
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
Shannon Smith, RN, BSN
Commentary
Navigating the CY 2025 CMS Physician Fee Schedule Proposals: Strategic Insights for Health Care Leaders
09/30/2024
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
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
The Clash Over Medicare: Key Lawsuits Challenging the IRA’s Drug Negotiation Provisions
07/11/2024
The IRA has spawned a series of lawsuits from pharmaceutical companies. Here, we provide the latest status updates on several of them.
The IRA has spawned a series of lawsuits from pharmaceutical companies. Here, we provide the latest status updates on several of them.
The IRA has spawned a series of...
07/11/2024
First Report Managed Care
Alison Lum Headshot
Interview
Transforming Pharmacy Care and Drug Payment Models: Expert Insights From Asembia 2024
06/06/2024
Alison Lum, PharmD, Vice President of Pharmacy Services at Blue Shield of California
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum,...
06/06/2024
First Report Managed Care
News
Analysis Shows Proposed CMS ‘Best Price’ Rule May Increase Rebate Liability, Impacting Medicaid
04/26/2024
A proposed rule from Centers for Medicare & Medicaid Services (CMS), “Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program,” has been in the spotlight recently. Major health...
A proposed rule from Centers for Medicare & Medicaid Services (CMS), “Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program,” has been in the spotlight recently. Major health...
A proposed rule from Centers for...
04/26/2024
First Report Managed Care
Christie Headshot
Commentary
How Medicare Advantage Plans Can Prepare for the CMS Health Equity Index
02/13/2024
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
Calum Yacoubian Headshot
Interview
Navigating Medicare Advantage Risk Adjustment Plan Changes
01/09/2024
Learn about significant changes in the Medicare Advantage Risk Adjustment model (transitioning from version 24 to 28) for payers and providers and the importance of accurate coding and the use of technologies like AI and natural language...
Learn about significant changes in the Medicare Advantage Risk Adjustment model (transitioning from version 24 to 28) for payers and providers and the importance of accurate coding and the use of technologies like AI and natural language...
Learn about significant changes...
01/09/2024
First Report Managed Care
Gould and Henry
Interview
Understanding the Implications of Medicare Advantage Growth
11/30/2023
Learn about the growth of Medicare Advantage and its impact on the health care industry. Michael Gould and Cindy Henry discuss the popularity of Medicare Advantage plans, the potential effects of new regulations, and the importance of strong...
Learn about the growth of Medicare Advantage and its impact on the health care industry. Michael Gould and Cindy Henry discuss the popularity of Medicare Advantage plans, the potential effects of new regulations, and the importance of strong...
Learn about the growth of...
11/30/2023
First Report Managed Care

Newsfeed

News
Study Suggests Innovative Value-Based Models for Expanding Cell and Gene Therapy Access
12/17/2024
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
Shannon Smith, RN, BSN
Commentary
Navigating the CY 2025 CMS Physician Fee Schedule Proposals: Strategic Insights for Health Care Leaders
09/30/2024
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
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
Alison Lum Headshot
Interview
Transforming Pharmacy Care and Drug Payment Models: Expert Insights From Asembia 2024
06/06/2024
Alison Lum, PharmD, Vice President of Pharmacy Services at Blue Shield of California
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum,...
06/06/2024
First Report Managed Care
News
Analysis Shows Proposed CMS ‘Best Price’ Rule May Increase Rebate Liability, Impacting Medicaid
04/26/2024
A proposed rule from Centers for Medicare & Medicaid Services (CMS), “Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program,” has been in the spotlight recently. Major health...
A proposed rule from Centers for Medicare & Medicaid Services (CMS), “Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program,” has been in the spotlight recently. Major health...
A proposed rule from Centers for...
04/26/2024
First Report Managed Care
Christie Headshot
Commentary
How Medicare Advantage Plans Can Prepare for the CMS Health Equity Index
02/13/2024
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
Calum Yacoubian Headshot
Interview
Navigating Medicare Advantage Risk Adjustment Plan Changes
01/09/2024
Learn about significant changes in the Medicare Advantage Risk Adjustment model (transitioning from version 24 to 28) for payers and providers and the importance of accurate coding and the use of technologies like AI and natural language...
Learn about significant changes in the Medicare Advantage Risk Adjustment model (transitioning from version 24 to 28) for payers and providers and the importance of accurate coding and the use of technologies like AI and natural language...
Learn about significant changes...
01/09/2024
First Report Managed Care
Gould and Henry
Interview
Understanding the Implications of Medicare Advantage Growth
11/30/2023
Learn about the growth of Medicare Advantage and its impact on the health care industry. Michael Gould and Cindy Henry discuss the popularity of Medicare Advantage plans, the potential effects of new regulations, and the importance of strong...
Learn about the growth of Medicare Advantage and its impact on the health care industry. Michael Gould and Cindy Henry discuss the popularity of Medicare Advantage plans, the potential effects of new regulations, and the importance of strong...
Learn about the growth of...
11/30/2023
First Report Managed Care
Headshots
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
News
Patient-Reported Outcomes Drive Value-Based Care in Multiple Sclerosis
01/13/2025
A recent study published in Journal of Managed Care & Specialty Pharmacy explored multiple sclerosis (MS) as a compelling therapeutic area for outcomes-based agreements (OBAs) by assessing the use of patient-reported disability progression to...
A recent study published in Journal of Managed Care & Specialty Pharmacy explored multiple sclerosis (MS) as a compelling therapeutic area for outcomes-based agreements (OBAs) by assessing the use of patient-reported disability progression to...
A recent study published in...
01/13/2025
First Report Managed Care
News
Study Highlights the Substantial Economic and Health Care Burden of Vitiligo
01/13/2025
Patients with vitiligo in the US face significantly higher health care costs and resource utilization compared with the general population, according to a study published in the Journal of Investigative Dermatology.
Patients with vitiligo in the US face significantly higher health care costs and resource utilization compared with the general population, according to a study published in the Journal of Investigative Dermatology.
Patients with vitiligo in the US...
01/13/2025
First Report Managed Care
News
Biosimilars Expand Access and Cut Costs in HER2-Positive Cancer Treatment
01/10/2025
Biosimilar versions of trastuzumab have rapidly gained market share in treating HER2-positive breast cancer since their introduction to the US markets.
Biosimilar versions of trastuzumab have rapidly gained market share in treating HER2-positive breast cancer since their introduction to the US markets.
Biosimilar versions of...
01/10/2025
First Report Managed Care
News
COVID-19 Infection Linked to Increased Risk of Skin Conditions
01/08/2025
A recent study found that COVID-19 infection significantly increases the risk of developing skin conditions such as vitiligo, chronic urticaria, alopecia areata, and herpes zoster.
A recent study found that COVID-19 infection significantly increases the risk of developing skin conditions such as vitiligo, chronic urticaria, alopecia areata, and herpes zoster.
A recent study found that...
01/08/2025
First Report Managed Care
Formoso Headshot
Videos
Minimally Invasive Solutions for Lumbar Disc Herniation
01/07/2025
In this interview, Ferdinand Formoso, DO, discusses the role of condoliase as a minimally invasive treatment for lumbar disc herniation, its safety profile, potential areas for further research, and its ability to address unmet needs in spine...
In this interview, Ferdinand Formoso, DO, discusses the role of condoliase as a minimally invasive treatment for lumbar disc herniation, its safety profile, potential areas for further research, and its ability to address unmet needs in spine...
In this interview, Ferdinand...
01/07/2025
First Report Managed Care
News
Provider Perceptions of Biosimilar Use in Oncology Networks
01/03/2025
Research published in the Journal of the American Pharmacists Association examined provider perceptions of barriers to biosimilar use in a large oncology network, revealing low levels of perceived barriers and high utilization rates, with...
Research published in the Journal of the American Pharmacists Association examined provider perceptions of barriers to biosimilar use in a large oncology network, revealing low levels of perceived barriers and high utilization rates, with...
Research published in the...
01/03/2025
First Report Managed Care
DeMarrais Headshot
Commentary
How Health Systems Can Meet the Expanding Needs of Specialty Pharmacies
01/03/2025
Health systems must adapt to the growing demand for specialty pharmacies by scaling services, embracing technology, and collaborating with experts to improve patient outcomes, reduce administrative burdens, and navigate regulatory challenges.
Health systems must adapt to the growing demand for specialty pharmacies by scaling services, embracing technology, and collaborating with experts to improve patient outcomes, reduce administrative burdens, and navigate regulatory challenges.
Health systems must adapt to the...
01/03/2025
First Report Managed Care
Varshney Headshot
Interview
Transforming Drug Development Through Real-World Evidence and Artificial Intelligence
01/03/2025
In this interview, Dr Jo Varshney, founder and CEO of VeriSIM Life, discusses the complexities of drug development, the role of AI in accelerating discovery, the integration of real-world evidence, and strategies to reduce costs while...
In this interview, Dr Jo Varshney, founder and CEO of VeriSIM Life, discusses the complexities of drug development, the role of AI in accelerating discovery, the integration of real-world evidence, and strategies to reduce costs while...
In this interview, Dr Jo...
01/03/2025
First Report Managed Care
KOL Headshots
Commentary
2024 Trends and 2025 Predictions: Insights From Health Care Leaders on Advancing Medicare, AI Solutions, and Clinical Data Utilization
12/27/2024
In this exclusive commentary for First Report Managed Care, health experts and business leaders explore how advancements in Medicare Advantage, ambient intelligence, generative AI, cybersecurity, risk adjustment, precision oncology, and AI...
In this exclusive commentary for First Report Managed Care, health experts and business leaders explore how advancements in Medicare Advantage, ambient intelligence, generative AI, cybersecurity, risk adjustment, precision oncology, and AI...
In this exclusive commentary for...
12/27/2024
First Report Managed Care

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