frmc Commentary

Commentary

Commentary

From Data to Decision: How Generative AI is Shaping Patient Care Pathways

03/20/2024

Kevin Riley, CEO, President, Zyter|TruCare; Avikar Govil, Insights Health Product Manager, Zyter|TruCare

Kevin Riley, CEO, President, Zyter|Tr...

The rapid evolution of Generative Artificial Intelligence (Gen AI) is fundamentally transforming the health care industry, ushering in an era of increased personalization, efficiency, and improved patient outcomes. In this commentary, experts...

The rapid evolution of...

03/20/2024

First Report Managed Care

Commentary

The Key to Improving Medication Adherence: The “Right” Medication for Each Patient

03/08/2024

James Wallace, CEO of DecisionRx

James Wallace, CEO of DecisionRx ...

Medication adherence poses a significant challenge in health care, with far-reaching consequences for patients and the health care system. It is a complex issue influenced by various factors, including undesirable side effects, lack of...

Medication adherence poses a...

03/08/2024

First Report Managed Care

Commentary

Next-Generation Utilization Management: Managing Utilization and Cost Without Denial of Service

03/01/2024

Amit Gupta, MD, Medical Director, Clinical Strategy at Sagility

Amit Gupta, MD, Medical Director, Cli...

Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.

Utilization management is...

03/01/2024

First Report Managed Care

Commentary

Unlocking Health Care Efficiency: CMS Overhauls Prior Authorization in Landmark Interoperability Rule—What Payers Need to Know Now

03/01/2024

Michael Gould, AVP, Interoperability Strategy at ZeOmega

Michael Gould, AVP, Interoperability ...

CMS has published the Interoperability and Prior Authorization final rule to drive transformative outcomes in the health care ecosystem, requiring payers and providers to adopt new standards and FHIR APIs to reduce inefficiencies and improve...

CMS has published the...

03/01/2024

First Report Managed Care

Commentary

What Insurance Plans Need to Know About Biomarker Legislation

02/14/2024

Alex Sommer, vice president, State Government Affairs, Avalon Healthcare Solutions

Alex Sommer, vice president, State Go...

Biomarker bills are merely the latest in what is likely to be a wave of legislation mandating coverage of new tests and therapies that are part of the growth in precision medicine. This will make it increasingly difficult for plans to control...

Biomarker bills are merely the...

02/14/2024

First Report Managed Care

Commentary

How Medicare Advantage Plans Can Prepare for the CMS Health Equity Index

02/13/2024

Christie Teigland, PhD, VP of Research Science and Advanced Analytics, Inovalon

Christie Teigland, PhD, VP of Researc...

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

Commentary

Request for FDA Approval: Prescription Digital Therapeutic Targeting Liver Disease With Breakthrough Device Designation

01/24/2024

Lisa Kuhns, PhD

In January 2024, Better Therapeutics, Inc submitted a request to the US Food and Drug Administration (FDA) for Breakthrough Device Designation for its new prescription digital therapeutic (PDT) designed to treat metabolic...

In January 2024, Better...

01/24/2024

First Report Managed Care

Commentary

2024 Predictions: Key Trends Identified by Business Leaders and Health Care Experts in Value-Based Care

01/23/2024

In this exclusive commentary for First Report Managed Care, health experts and business leaders share insights into predictions for the 2024 value-based care landscape. Insights highlight trends in behavioral health, AI integration,...

In this exclusive commentary for...

01/23/2024

First Report Managed Care

Commentary

New Partnership Integrates AspyreRx Digital Treatment for Type 2 Diabetes

01/12/2024

Lisa Kuhns, PhD

In January 2024, Better Therapeutics Inc. and Glooko Inc. announced a partnership to integrate Better Therapeutics’ AspyreRx™ digital behavioral treatment for type 2 diabetes (T2D) into Glooko’s diabetes management platform.

In January 2024, Better...

01/12/2024

First Report Managed Care

Commentary

2025–2026 Star Ratings: The Path to Success

01/09/2024

Ashley McNairy, senior product director, Cotiviti

Ashley McNairy, senior product direct...

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

Current Issue

June 2024

Volume 21

Issue 2

Current Issue

Issue Archive

What's Trending?

News

Express Scripts Reports Prescription Drug Spending Slowed in 2016

02/06/2017

The pharmacy benefit manager, Express Scripts, reported that growth in prescription drug spending slowed to less than 4% between 2015 and 2016.

The pharmacy benefit manager,...

02/06/2017

First Report Managed Care

News

Substantial Economic Burden Associated With Lupus Nephritis

12/17/2021

Jolynn Tumolo

“The consensus across the 22 studies was that the economic burden of lupus nephritis is substantial,” researchers wrote, “particularly in active or severe disease, or if there is progression to end-stage kidney disease.”

“The consensus across the 22...

12/17/2021

First Report Managed Care

Study Identifies Cost of Having a Baby in the United States

04/22/2013

Tori Socha

There are 3 goals in healthcare: (1) improved care, (2) improved outcomes, and (3) lower costs. Maternity care, which impacts approximately 85% of women during 1 or more episodes of care, provides opportunity for improvements in healthcare...

There are 3 goals in healthcare:...

04/22/2013

First Report Managed Care

News

J&J arthritis drug shows promise in mid-stage trial

06/07/2011

First Report Managed Care

News

Wrinkle in Health Law Vexes Lawmakers’ Aides

07/30/2013

First Report Managed Care

Video Insights

Videos

Evolving Health Care Contact Centers Into Drivers of Value-Based Care

07/31/2024

Discover how health care contact centers can transform into drivers of value-based care through AI, automation, upskilling agents, and rethinking workflows and metrics to improve patient outcomes and population health.

Discover how health care contact...

07/31/2024

First Report Managed Care

Videos

Enhancing Patient Medication Adherence: Insights and Strategies From Asembia 2024

06/11/2024

Lucille Accetta, PharmD, MBA, MSPH, Senior Vice President of CVS Specialty Operations

Key stakeholders in the health care industry gathered to discuss prevalent topics at this year's Asembia annual summit. Medication adherence emerged as one of the most talked-about issues. In a session led by Lucille Accetta, PharmD, MBA,...

Key stakeholders in the health...

06/11/2024

First Report Managed Care

Melissa Andel, Principal, CommonHealth Solutions, LLC

Videos

Navigating the Impact of the Inflation Reduction Act: Implications for Payers, Patients, and Manufacturers

05/24/2024

Melissa Andel, Principal, CommonHealth Solutions, LLC

Learn about the impacts of the Inflation Reduction Act on payers and patients, highlighting the changes in Medicare benefits and drug coverage coming in 2025 and 2026.

Learn about the impacts of the...

05/24/2024

First Report Managed Care

Videos

Navigating Payment Models in the CGT Landscape: Insights and Innovations

05/21/2024

Joe DePinto, Head of Cell, Gene, and Advanced Therapies, McKesson

An expert discusses the evolution and challenges of payment models in the cell and gene therapy (CGT) space reviewed during his session at Asembia 2024.

An expert discusses the...

05/21/2024

First Report Managed Care

Jennifer L. Mathieu Senior Vice President, Professional and Government Affairs at AMCP

Videos

Unlocking the Future of Managed Care Pharmacy: A Deep Dive into Federal Legislation and Regulations

05/15/2024

Jennifer L. Mathieu Senior Vice President, Professional and Government Affairs, AMCP

Learn about developments in federal legislation and regulations within the pharmacy landscape shaping the future of managed care in an interview with a session presenter from AMCP 2024.

Learn about developments in...

05/15/2024

First Report Managed Care

Videos

Personalizing Weight Loss Management With GLP-1 Agonists

04/05/2024

Featuring Tejaswi Kompala, MD, head of cardiometabolic clinical strategy, Teladoc

Featuring Tejaswi Kompala, MD, head o...

Delve into the rising demand for anti-obesity medications, the complexities of obesity management, and the importance of personalized approaches in improving cardiometabolic health in this insightful interview.

Delve into the rising demand for...

04/05/2024

First Report Managed Care

Videos

Integrating Behavioral Health Services to Reduce ED Visits: Substance Use Disorder and Social Determinants of Health

03/27/2024

Featuring Tom Zaubler, MD, MPH, CMO at NeuroFlow

Featuring Tom Zaubler, MD, MPH, CMO a...

Join us for the continuation of an engaging two-part series showcasing an expert dedicated to reducing emergency department visits through the integration of behavioral health practices. Dr Zaubler will share invaluable insights into...

Join us for the continuation of...

03/27/2024

First Report Managed Care

Videos

Integrating Behavioral Health Services to Reduce ED Visits: Suicide Prevention and Preemptive Primary Care

03/25/2024

Featuring Tom Zaubler, MD, MPH, CMO at NeuroFlow

Featuring Tom Zaubler, MD, MPH, CMO a...

Come join us for the first installment of a captivating two-part series featuring an expert committed to minimizing emergency department visits through the implementation of behavioral health integrations. Dr Zaubler will offer valuable...

Come join us for the first...

03/25/2024

First Report Managed Care

Videos

Navigating the Evolution of Digital Solutions in Health Care

02/27/2024

Featuring Yash Prajapati, consultant at ZS Associates

Featuring Yash Prajapati, consultant ...

Join us in exploring the challenges and opportunities in the development, approval, and integration of digital therapeutic solutions with ZS Associates consultant Yash Prajapati.

Join us in exploring the...

02/27/2024

First Report Managed Care

Videos

Advancements and Challenges in Diabetes Management

02/27/2024

Featuring Mansur Shomali, MD, chief medical officer at Welldoc, endocrinologist at MedStar Health

Featuring Mansur Shomali, MD, chief m...

Learn about the state of digital therapeutics for disease management such as diabetes care in terms of cost, outcomes, integration, and more with Dr Mansur Shomali, CMO at Welldoc.

Commentary

Current Issue

What's Trending?

Video Insights

Subscribe to our eNewsletters!

Specialties

Events

Year Round Education

HMP Global Products