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Commentary

Jason Oswald Headshot
Commentary
The Impact of AI on Health Carrier Underwriting: Insights From Industry Experts
11/08/2024
"As AI continues to evolve, its integration into group health underwriting offers carriers new opportunities to enhance decision-making, streamline operations, and improve overall plan performance," said Jason Oswald, Director of Solution...
"As AI continues to evolve, its integration into group health underwriting offers carriers new opportunities to enhance decision-making, streamline operations, and improve overall plan performance," said Jason Oswald, Director of Solution...
"As AI continues to evolve, its...
11/08/2024
First Report Managed Care
Hawley Headshot
Commentary
Beyond Medical Cost Savings: Optimizing Payment Integrity Value
10/31/2024
Health plan leaders increasingly recognize the value of utilizing technology as a counteroffensive against high medical loss ratios, which are now close to 90% in the large group market. As the industry is poised to face the same pressures in...
Health plan leaders increasingly recognize the value of utilizing technology as a counteroffensive against high medical loss ratios, which are now close to 90% in the large group market. As the industry is poised to face the same pressures in...
Health plan leaders increasingly...
10/31/2024
First Report Managed Care
Milo Headshot
Commentary
Transforming Health Care Payer Operations With AI
10/11/2024
Health plans today face mounting pressure to enhance member engagement while improving health outcomes and control rising costs. As health care inflation continues to outpace general inflation across the United States, health plans are...
Health plans today face mounting pressure to enhance member engagement while improving health outcomes and control rising costs. As health care inflation continues to outpace general inflation across the United States, health plans are...
Health plans today face mounting...
10/11/2024
First Report Managed Care
Lynn Carroll
Commentary
How Capitation Contracts Can Benefit Provider and Payer Population Health Initiatives
10/04/2024
In response to the vulnerabilities exposed by the COVID-19 pandemic, provider organizations are increasingly turning to capitation payment models to ensure revenue stability, improve care quality, and manage population health.
In response to the vulnerabilities exposed by the COVID-19 pandemic, provider organizations are increasingly turning to capitation payment models to ensure revenue stability, improve care quality, and manage population health.
In response to the...
10/04/2024
First Report Managed Care
Mike Spellman
Commentary
Unlocking Value in Payment Integrity: A New Paradigm for Health Insurers
10/01/2024
From cost-cutting to value creation, learn how payment integrity is shifting towards a more holistic approach in the health care industry to enhance care quality and stakeholder relationships.
From cost-cutting to value creation, learn how payment integrity is shifting towards a more holistic approach in the health care industry to enhance care quality and stakeholder relationships.
From cost-cutting to value...
10/01/2024
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
Noel Felipe
Commentary
Providers Can Reduce Administrative Burden and Improve Productivity With AI Tools to Mitigate Labor Shortages
09/30/2024
As labor shortages continue to plague the health care industry, providers are turning to artificial intelligence tools to streamline administrative tasks, enhance patient care, and improve staff satisfaction, offering a glimpse into the...
As labor shortages continue to plague the health care industry, providers are turning to artificial intelligence tools to streamline administrative tasks, enhance patient care, and improve staff satisfaction, offering a glimpse into the...
As labor shortages continue to...
09/30/2024
First Report Managed Care
Commentary
Enhancing Provider Experience Through Electronic Prior Authorization
08/13/2024
Each year the American Medical Association (AMA) surveys its membership to ascertain their feedback concerning prior authorizations (PAs) and the impact of this service on their practice. Reliably, AMA members say that PAs are disruptive to...
Each year the American Medical Association (AMA) surveys its membership to ascertain their feedback concerning prior authorizations (PAs) and the impact of this service on their practice. Reliably, AMA members say that PAs are disruptive to...
Each year the American Medical...
08/13/2024
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
Commentary
Easing the Nursing Shortage Burden With Wins on Quality, Cost, Scale
07/10/2024
Already challenged with cost, care, and administrative pressures, health care organizations are now staring down a daunting talent supply-and-demand gap. This shortage will negatively affect affordability and access to care for consumers and...
Already challenged with cost, care, and administrative pressures, health care organizations are now staring down a daunting talent supply-and-demand gap. This shortage will negatively affect affordability and access to care for consumers and...
Already challenged with cost,...
07/10/2024
First Report Managed Care
FRMC Volume 21, Issue 3

Current Issue

September 2024
Volume 21
Issue 3
Current Issue
Issue Archive

What's Trending?

News
Improving, Optimizing Treatment for Migraine
11/16/2018
During a session at the Scottsdale Headache Symposium 2018, Michael Ready, MD, FAHS, discussed how to develop an effective migraine preventative plan.
During a session at the Scottsdale Headache Symposium 2018, Michael Ready, MD, FAHS, discussed how to develop an effective migraine preventative plan.
During a session at the...
11/16/2018
First Report Managed Care
News
CMS report: Reforms will save Medicare nearly $8 billion through next year
08/03/2010
08/03/2010
First Report Managed Care
Department
Costs Similar Among Multiple Myeloma Patients Treated With Kyprolis vs Pomalyst
01/23/2017
According to recent research presented at the 2016 ASH Annual Meeting and Exposition, multiple myeloma treatment costs are not significantly different when using Kyprolis (carfilzomib; Amgen) compared to treatment with Pomalyst (pomalidomide;...
According to recent research presented at the 2016 ASH Annual Meeting and Exposition, multiple myeloma treatment costs are not significantly different when using Kyprolis (carfilzomib; Amgen) compared to treatment with Pomalyst (pomalidomide;...
According to recent research...
01/23/2017
First Report Managed Care
News
Medicare Releases Patient Safety Ratings For Hospitals
12/06/2011
12/06/2011
First Report Managed Care
News
Cardiovascular Risk Scores Overestimate Likelihood of Cardiovascular Events
02/16/2015
Four of 5 common cardiovascular risk scores overestimate the likelihood of cardiovascular events by as much as 115%, researchers report.
Four of 5 common cardiovascular risk scores overestimate the likelihood of cardiovascular events by as much as 115%, researchers report.
Four of 5 common cardiovascular...
02/16/2015
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 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
Richard Lipton, MD
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 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
Alexander Spira, MD, PhD
Videos
Unmet Needs in the Treatment and Management of Non–Small Cell Lung Cancer
09/26/2024
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, 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 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
Title Card
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 Demodex blepharitis, a prevalent ocular condition that often goes undiagnosed in patients.
View a roundtable discussion on...
09/04/2024
First Report Managed Care
Jordan Bazinsky
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 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
Farrukh Awan, MD
Videos
Promising Therapies and Clinical Trials for Chronic Lymphocytic Leukemia
08/14/2024
Farrukh Awan, MD, highlights promising therapies and clinical trials within the field of chronic lymphocytic leukemia (CLL).
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
Hayward
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 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
Lucille Accetta Headshot
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 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 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

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