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Pratt Headshot
Commentary
Time: The Critical Resource Rural Hospitals Can’t Afford to Waste
09/26/2025
Mark Pratt
Rural health care staff members don’t just wear many hats—they often wear them all at once. In many communities, one person might be handling registration, billing, and collections while also answering phones or covering a front desk. When...
Rural health care staff members don’t just wear many hats—they often wear them all at once. In many communities, one person might be handling registration, billing, and collections while also answering phones or covering a front desk. When...
Rural health care staff members...
09/26/2025
First Report Managed Care
Holt Headshot
Commentary
Escaping the Black Hole: Why Post-Acute Blind Spots Are Hospitals’ Biggest Value-Based Risk
09/26/2025
To succeed under new CMS value-based care models, hospitals must close the “post-acute black hole” by improving data exchange, strengthening care transitions, building high-quality post-acute partnerships, and leveraging predictive and...
To succeed under new CMS value-based care models, hospitals must close the “post-acute black hole” by improving data exchange, strengthening care transitions, building high-quality post-acute partnerships, and leveraging predictive and...
To succeed under new CMS...
09/26/2025
First Report Managed Care
Vashi Headshot
Commentary
Optimizing Risk Adjustment and Quality Measurement With AI
09/15/2025
Deepan Vashi
As we’ve covered in the earlier entries in this series, artificial intelligence (AI) is proving useful in streamlining health plan operations of all sorts. AI tools can also augment human expertise for optimal results in less structured but...
As we’ve covered in the earlier entries in this series, artificial intelligence (AI) is proving useful in streamlining health plan operations of all sorts. AI tools can also augment human expertise for optimal results in less structured but...
As we’ve covered in the earlier...
09/15/2025
First Report Managed Care
Cell & Gene Watch
Scaling CGT Capacity for a Growing Pipeline: Current Progress and Ongoing Hurdles
08/28/2025
Joe DePinto
The cell and gene therapy pipeline is rapidly expanding into new disease areas, but realizing its full potential will require manufacturing innovation, value chain coordination, and new pricing models to balance cost, access, and scale.
The cell and gene therapy pipeline is rapidly expanding into new disease areas, but realizing its full potential will require manufacturing innovation, value chain coordination, and new pricing models to balance cost, access, and scale.
The cell and gene therapy...
08/28/2025
First Report Managed Care
Regulatory Insights
Five Things to Know About HR 1
08/25/2025
Adam Colborn, JD
HR 1 marks a major shift in health care policy, reshaping Medicaid and insurance marketplaces in ways that increase churn, reduce coverage, and cut funding—changes that managed care organizations must navigate amid rising political and...
HR 1 marks a major shift in health care policy, reshaping Medicaid and insurance marketplaces in ways that increase churn, reduce coverage, and cut funding—changes that managed care organizations must navigate amid rising political and...
HR 1 marks a major shift in...
08/25/2025
First Report Managed Care
Commentary
The Case for Aligning Behavioral and Primary Care in Managed Care
08/22/2025
Lynn Carroll
The Centers for Medicare & Medicaid Services PC Flex Model is accelerating behavioral health integration by giving accountable care organizations the financial flexibility to deliver whole-person care, bridging longstanding gaps in access,...
The Centers for Medicare & Medicaid Services PC Flex Model is accelerating behavioral health integration by giving accountable care organizations the financial flexibility to deliver whole-person care, bridging longstanding gaps in access,...
The Centers for Medicare &...
08/22/2025
First Report Managed Care
Vashi
Commentary
Supercharging Digital Twins With Artificial Intelligence Tools
07/29/2025
Deepan Vashi
Digital twins are virtual models of processes, systems, and/or physical objects—including people. A digital twin uses data gathered from sensors, databases, wearables, and applications to simulate how its real-world twin operates. Twins can...
Digital twins are virtual models of processes, systems, and/or physical objects—including people. A digital twin uses data gathered from sensors, databases, wearables, and applications to simulate how its real-world twin operates. Twins can...
Digital twins are virtual models...
07/29/2025
First Report Managed Care
Fisher Headshot
Commentary
Deciphering Early Signals That Shape Future Therapies
07/07/2025
Ian Fisher
In today’s high-stakes, fast-paced environment for drug development, actions taken in the early stages of research and development (R&D) are shaping more than just clinical pathways. These decisions are helping define the future of drug...
In today’s high-stakes, fast-paced environment for drug development, actions taken in the early stages of research and development (R&D) are shaping more than just clinical pathways. These decisions are helping define the future of drug...
In today’s high-stakes,...
07/07/2025
First Report Managed Care
Beery Headshot
Commentary
Medicaid Cuts Will Endanger the United States’ Most Vulnerable Children
06/19/2025
Taylor Beery
Recently, House and Senate Republicans introduced a sweeping package of Medicaid cuts that would fundamentally reshape the program—reducing enrollment, adding new eligibility barriers, and threatening the care of millions of children. These...
Recently, House and Senate Republicans introduced a sweeping package of Medicaid cuts that would fundamentally reshape the program—reducing enrollment, adding new eligibility barriers, and threatening the care of millions of children. These...
Recently, House and Senate...
06/19/2025
First Report Managed Care
Vashi Headshot
Commentary
Transforming Appeals and Grievances With Multimodal and Agentic AI
06/17/2025
Deepan Vashi
Discover how leading health plans are using multimodal and agentic AI to transform appeals and grievances—cutting costs, improving compliance, and delivering faster decisions.
Discover how leading health plans are using multimodal and agentic AI to transform appeals and grievances—cutting costs, improving compliance, and delivering faster decisions.
Discover how leading health...
06/17/2025
First Report Managed Care

Behind the Bill

Behind the Bill
The Senate’s $3 Trillion Deal. Tax Relief Now, Medicaid Coverage Loss Later?
07/02/2025
Katie Hayes, MJ
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After...
07/02/2025
First Report Managed Care
Behind the Bill
When a Cap Isn’t Just a Cap: How a Provider Tax Proposal Could Reshape Medicaid Financing
06/25/2025
Katie Hayes, MJ
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most...
06/25/2025
First Report Managed Care
Behind the Bill
Rewriting the Safety Net? Inside the Senate’s Changes to Medicaid and the ACA
06/18/2025
Katie Hayes, MJ
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve...
06/18/2025
First Report Managed Care
Behind the Bill
How States Might Respond to the One Big Beautiful Bill Act
06/11/2025
Katie Hayes, MJ
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill...
06/11/2025
First Report Managed Care
Behind the Bill
Is the Affordable Care Act on the Chopping Block? What the One Big Beautiful Bill Act Tells Us.
06/04/2025
Katie Hayes, MJ
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of...
06/04/2025
First Report Managed Care
Behind the Bill
From House to Senate: The Journey of Cutting Medicaid
05/28/2025
Katie Hayes, MJ
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of...
05/28/2025
First Report Managed Care
Behind the Bill
Eligibility, Paperwork, and Penalties: The Not-So-Hidden Costs of Medicaid ‘Reform’
05/21/2025
Katie Hayes, MJ
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week...
05/21/2025
First Report Managed Care
Behind the Bill
A Busy Week in Drug Pricing Policy: Aligning US Drug Prices With Global Standards?
05/14/2025
Katie Hayes, MJ
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for...
05/14/2025
First Report Managed Care
BEHIND THE BILL
When Agencies Lose Power: How 3 Seismic Shifts are Transforming Pharmaceutical Regulation
05/07/2025
Katie Hayes, MJ
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months,...
05/07/2025
First Report Managed Care
Behind the Bill
The Medicare Paradox, Part 3: Strategic Trade Doesn’t Have to be a Zero-Sum Game
05/07/2025
Katie Hayes, MJ
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve...
05/07/2025
First Report Managed Care

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Trending Articles

News
Targeted Medicine and Biological Therapies Fighting Type 2 Inflammation in Patients With Asthma
12/20/2023
Emry Lloyd
In a recent review, Imran Howell, University of Oxford, UK, and colleagues sought to understand the impact of biological therapies and targeted medicines for type 2 inflammation in patients with asthma.
In a recent review, Imran Howell, University of Oxford, UK, and colleagues sought to understand the impact of biological therapies and targeted medicines for type 2 inflammation in patients with asthma.
In a recent review, Imran...
12/20/2023
First Report Managed Care
News
Dairy, Gluten Show No Major Effect on MS Activity and Quality of Life
02/15/2024
Jolynn Tumolo
Dairy and gluten intake had no substantial effects on disease activity and quality of life in a retrospective study of 186 patients with multiple sclerosis (MS). Researchers published their findings online in Multiple Sclerosis Journal –...
Dairy and gluten intake had no substantial effects on disease activity and quality of life in a retrospective study of 186 patients with multiple sclerosis (MS). Researchers published their findings online in Multiple Sclerosis Journal –...
Dairy and gluten intake had no...
02/15/2024
First Report Managed Care
News
Health Care Administration Inefficiencies: Lessons from the 2024 Medallion Report
03/26/2024
Hannah Musick
Discover the impact of manual processes and staffing challenges on payer enrollment and credentialing workflows in the 2024 State of Payer Enrollment and Credentialing Report by Medallion.
Discover the impact of manual processes and staffing challenges on payer enrollment and credentialing workflows in the 2024 State of Payer Enrollment and Credentialing Report by Medallion.
Discover the impact of manual...
03/26/2024
First Report Managed Care
IPF letters
Formulary Frontlines®
New Therapies in Development for Idiopathic Pulmonary Fibrosis (IPF) Address Existing Challenges With Diagnosis and Management
05/13/2024

Reviewed by Elizabeth Volkmann, MD, MS

Reviewed by Elizabeth Volkmann, MD, M...
IPF is a chronic, progressive interstitial lung disease that presents a significant burden to ~3 million patients worldwide. Despite ongoing challenges with IPF diagnosis and management, new therapies in development are showing promise.
IPF is a chronic, progressive interstitial lung disease that presents a significant burden to ~3 million patients worldwide. Despite ongoing challenges with IPF diagnosis and management, new therapies in development are showing promise.
IPF is a chronic, progressive...
05/13/2024
First Report Managed Care
Conference Coverage
Immune Colitis Associated With Rituximab Therapy in Relapsing Multiple Sclerosis
05/24/2024
Hannah Musick
A case study highlighted rare immune colitis associated with rituximab therapy in a patient with relapsing multiple sclerosis (RMS) and emphasizes the need for increased awareness and monitoring of this potential adverse effect in clinical...
A case study highlighted rare immune colitis associated with rituximab therapy in a patient with relapsing multiple sclerosis (RMS) and emphasizes the need for increased awareness and monitoring of this potential adverse effect in clinical...
A case study highlighted rare...
05/24/2024
First Report Managed Care

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