frmc Commentary

Commentary

Medicare Advantage: Informing Beneficiaries to Address SDoH, Reduce Food Insecurity

11/19/2021

"The first step [to reduce food insecurity] is helping to ensure each person who’s eligible takes advantage of the benefits they’re entitled to receive," says Phil Wilkins about informing older adults of plan benefits.

"The first step [to reduce food...

11/19/2021

First Report Managed Care

Commentary

Diabetes Awareness Month: Nutrition Tips for Managing Type 2 Diabetes and ADPKD

11/18/2021

German Hernandez , MD;

German Hernandez, MD, provides nutrition tips for patients living with autosomal dominant polycystic kidney disease and stresses that “incorporating them into a patient’s routine as soon as diagnosis is confirmed may make a difference in...

German Hernandez, MD, provides...

11/18/2021

First Report Managed Care

Commentary

Advanced Analytics to Reduce Costs: Bridging the Behavioral Health Care Gap

11/11/2021

Sheila Talton ;

"Advanced analytics are essential for providers and payers to effectively manage behavioral health conditions as part of a value-based care strategy that rewards improved patient outcomes and lower health care costs," writes Sheila Talton,...

"Advanced analytics are...

11/11/2021

First Report Managed Care

Commentary

Course Helps Providers, Payers Measure Quality to Improve HIV Medication Use

11/09/2021

Amanda Ryan , PharmD, BCGP, CPHQ;

In this commentary, Amanda Ryan, PharmD, BCGP, CPHQ, describes how pharmacists, clinicians, and payers can enhance outcomes and lower costs with a new course by the Pharmacy Quality Alliance aimed at improving quality measurement in HIV care.

In this commentary, Amanda Ryan,...

11/09/2021

First Report Managed Care

Calum Yacoubian, MD, associate director of NLP health care strategy, Linguamatics, an IQVIA company

Commentary

How Payers Are Using AI to Address Big Data Challenges

11/05/2021

Calum Yacoubian , MD;

"To make the right decisions in risk adjustment, care gap closure, and patient outreach, payers need accurate, reliable data," writes Calum Yacoubian, MD. "With AI-powered technologies such as [natural language processing], payers can finally...

"To make the right decisions in...

11/05/2021

First Report Managed Care

Commentary

Success Story: Molina’s Groundbreaking SDoH Strategy Improves Health Outcomes With Personalization

11/04/2021

Icario Team

In this commentary, the Icario team reviews key takeaways from a webinar in which Lynette Hansen, associate vice president of Quality and Risk Adjustment at Molina Healthcare, shared insights about Molina's strategies to address social...

In this commentary, the Icario...

11/04/2021

First Report Managed Care

Commentary

The Future of Virtual Chronic Care Management

11/03/2021

Anthony Comfort ;

"The industry is now in a position where it must embrace new, more creative approaches to increasing health care access. One of the answers may lie in virtual chronic care management," says Anthony Comfort, SVP of product management,...

"The industry is now in a...

11/03/2021

First Report Managed Care

Gina Kim is the Chief Product Officer at Cohere Health, a digital prior authorization company

Commentary

New Prior Authorization Regulations: Making Lemonade Out of Lemons

10/19/2021

Gina Kim ;

“Health plans still relying on manual or partially automated prior authorization processes will clearly need to invest in technology to comply with upcoming regulations,” says Gina Kim, chief product officer, Cohere Health. “Turning...

“Health plans still relying on...

10/19/2021

First Report Managed Care

Commentary

2022 CMS Star Ratings, Impact, and Implications

10/15/2021

Sara Ratner ;

In this commentary, Sara Ratner, senior vice president of Government Markets and Strategic Initiatives at Icario, discusses how star ratings have changed during the pandemic and emphasizes what health plans can do to improve member...

In this commentary, Sara Ratner,...

10/15/2021

First Report Managed Care

Commentary

HIV Guidelines: Quick Hitters From the Recent HHS Update

10/07/2021

Douglas L. Jennings , PharmD, FACC, FAHA, FCCP, FHFSA, BCPS;

“As the number of HIV treatment options have burgeoned and patient management has democratized well beyond HIV specialists into fields such as primary and family care, clinicians are compelled to remain abreast of key practice updates,” says...

“As the number of HIV treatment...

10/07/2021

First Report Managed Care

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Is Sitting Just As Dangerous As Smoking?

01/20/2015

Kerri Fitzgerald ;

Emerging research has indicated that it is possible to meet current daily physical activity guidelines while still being too sedentary, which increases the risk of death and disease despite physical activity that is taking place.

Emerging research has indicated...

01/20/2015

First Report Managed Care

News

GOP raises more questions about healthcare waivers

08/15/2011

First Report Managed Care

Best Practices in Medicaid Claims Administration and Oversight

12/02/2014

Every Medicaid operation needs high-performing claims administration. With strict medical loss ratios as required by healthcare reform, ongoing regulatory changes, timeliness, and payment accuracy relevant to provider pricing and benefit...

Every Medicaid operation needs...

12/02/2014

First Report Managed Care

News

U.S. warns Aetna over Medicare prescription policies

04/12/2010

First Report Managed Care

News

Biologics: Changing the Treatment Scope for Psoriasis and Psoriatic Arthritis: References

12/01/2014

NULL

References 1. Levy LL, Solomon SM, Emer JJ. Biologics in the treatment of psoriasis and emerging new therapies in the pipeline. Psoriasis: Targets and Therapy. 2012;2:29-43. 2. Bhosle MJ, Kulkarni A, Feldman SR, Balkrishnan. Quality of life...

References 1. Levy LL, Solomon...

12/01/2014

First Report Managed Care

Video Insights

Videos

Bridging the Gaps in Prior Authorization: Challenges, Solutions, and Collaboration for Better Patient Care

11/13/2024

David Sand, MD, MBA, chief medical officer at ZeOmega, discusses the challenges of prior authorization, emphasizing the need for transparency, evidence-based standards, collaboration between payers and providers, and the potential for...

David Sand, MD, MBA, chief...

11/13/2024

First Report Managed Care

Videos

The Evolving Role of CGRP-targeting Therapies in Migraine Prevention

10/31/2024

Richard Lipton, MD, provides insights on the American Headache Society’s position statement update on calcitonin gene-related peptide (CGRP)-targeting therapies as a first-line option for the prevention of migraine.

Richard Lipton, MD, provides...

10/31/2024

First Report Managed Care

Videos

Unmet Needs in the Treatment and Management of Non–Small Cell Lung Cancer

09/26/2024

Alexander Spira , MD, PhD;

Alexander I. Spira, MD, PhD, discusses significant unmet needs in the treatment and management of non–small cell lung cancer (NSCLC).

Alexander I. Spira, MD, PhD,...

09/26/2024

First Report Managed Care

Videos

Treatment Options for NSCLC: A Discussion on Coverage, Clinical Outcomes, and Payer Perspectives

09/25/2024

Learn about research developments in 1L therapy for NSCLC patients with EGFR mutations and how outcomes may impact coverage and reimbursement decisions for insurers.

Learn about research...

09/25/2024

First Report Managed Care

Videos

Addressing the Root Cause of a Common Ocular Condition: A Virtual Roundtable

09/04/2024

View a roundtable discussion on Demodex blepharitis, a prevalent ocular condition that often goes undiagnosed in patients.

View a roundtable discussion on...

09/04/2024

First Report Managed Care

Videos

Addressing Health Disparities and Promoting Equity: The Role of Advanced Imaging Solutions

08/15/2024

Guest expert Jordan Bazinsky discusses the challenges facing the medical imaging industry, the potential of AI and emerging technologies, the role of advanced imaging solutions in promoting health equity, and the key trends and challenges...

Guest expert Jordan Bazinsky...

08/15/2024

First Report Managed Care

Videos

Promising Therapies and Clinical Trials for Chronic Lymphocytic Leukemia

08/14/2024

Farrukh T. Awan , MD;

Farrukh Awan, MD, highlights promising therapies and clinical trials within the field of chronic lymphocytic leukemia (CLL).

Farrukh Awan, MD, highlights...

08/14/2024

Journal of Clinical Pathways

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.

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