frmc Commentary

Commentary

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

03/01/2024

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 ;

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;

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, MD;

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, MD;

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 ;

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

Commentary

The Hidden Threat: Heart Failure in Elderly Diabetic Populations

01/04/2024

Sean Brady ;

The correlation between diabetes and heart failure poses a significant risk, as almost one-third of elderly individuals with diabetes encounter heart failure. Sean Brady provides insights into upcoming innovative solutions aimed at addressing...

The correlation between diabetes...

01/04/2024

First Report Managed Care

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...

12/21/2023

First Report Managed Care

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September 2024

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Managing Chronic Kidney Disease in Older Adults

11/03/2014

Eileen Koutnik-Fotopoulos ;

Chronic kidney disease is pervasive in the older population. The progression of CKD can have a significant affect on the overall prognosis of a geriatric patient.

Chronic kidney disease is...

11/03/2014

First Report Managed Care

News

Retirement, health insurance commonly targeted

08/04/2011

First Report Managed Care

News

US Government Proposes More Transparency in Clinical Trials

11/19/2014

Health officials proposed significantly expanding what researchers are required to report about clinical trials of drugs, devices, and other interventions.

Health officials proposed...

11/19/2014

First Report Managed Care

News

Device Could Reduce Direct Medical Costs For Patients with COPD

11/15/2017

Recent research in the International Journal of COPD found that a handheld mechanical oscillating positive expiratory pressure device could significantly improve post-exacerbation care.

Recent research in...

11/15/2017

First Report Managed Care

News

Pelosi: Public option will not be in health bill despite liberal efforts

03/12/2010

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

Conference Coverage

Using Lenalidomide and Rituximab, Tazemetostat, or Bispecific Antibodies to Treat Patients With Follicular Lymphoma

04/06/2024

Featuring Peter Martin, MD

During the 2024 Great Debates & Updates in Hematologic Malignancies meeting in New York, Peter Martin, MD, argued in favor of alternative treatment regimens over CAR T-cell therapy for treating follicular lymphoma.

During the 2024 Great Debates &...

04/06/2024

Oncology

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.

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