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August 2011 - FRMC

Reducing the Amount of Phlebotomy Ordered for Nonintensive Care Unit Surgical Patients
08/23/2011
Tori Socha
According to researchers, use of laboratory tests has increased continuously over the past few decades.
According to researchers, use of laboratory tests has increased continuously over the past few decades.
According to researchers, use of...
08/23/2011
First Report Managed Care
Surgical Intervention Not Always Needed for Pneumatosis Intestinalis
08/23/2011
Christin Melton
Pneumatosis intestinalis (PI), a potentially fatal occurrence, is often treated surgically, but new data from a retrospective study suggest many patients with PI are good candidates for nonoperative management. Investigators for the study,...
Pneumatosis intestinalis (PI), a potentially fatal occurrence, is often treated surgically, but new data from a retrospective study suggest many patients with PI are good candidates for nonoperative management. Investigators for the study,...
Pneumatosis intestinalis (PI), a...
08/23/2011
First Report Managed Care
Sirolimus-Eluting Stents versus CABG in Unprotected Left Main Coronary Stenosis
08/23/2011
Christin Melton
A Korean study found percutaneous coronary intervention with sirolimus-eluting stents noninferior to coronary artery bypass grafting in patients.
A Korean study found percutaneous coronary intervention with sirolimus-eluting stents noninferior to coronary artery bypass grafting in patients.
A Korean study found...
08/23/2011
First Report Managed Care
Treating Mitral Regurgitation with Percutaneous Repair or Surgery
08/23/2011
Tori Socha
Progressive left ventricular dysfunction and congestive heart failure have been associated with severe mitral regurgitation. Left untreated, symptomatic patients have an annual rate of ≥5%. Symptoms can be managed medically, but this strategy...
Progressive left ventricular dysfunction and congestive heart failure have been associated with severe mitral regurgitation. Left untreated, symptomatic patients have an annual rate of ≥5%. Symptoms can be managed medically, but this strategy...
Progressive left ventricular...
08/23/2011
First Report Managed Care
Age Predicts 90-Day Mortality in PPCI Patients
08/23/2011
Mary Mihalovic
Age was the strongest predictor of 90-day mortality among patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) for reperfusion, according to results of a recent study...
Age was the strongest predictor of 90-day mortality among patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) for reperfusion, according to results of a recent study...
Age was the strongest predictor...
08/23/2011
First Report Managed Care
PPCI Shows a Significant Mortality Benefit in High-Risk Patients Only
08/23/2011
Mary Mihalovic
As a reperfusion strategy, thrombolysis has been shown to have similar benefit with regard to mortality as primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI) who are not...
As a reperfusion strategy, thrombolysis has been shown to have similar benefit with regard to mortality as primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI) who are not...
As a reperfusion strategy,...
08/23/2011
First Report Managed Care
Use of CTPA in Diagnosis of Pulmonary Embolism
08/23/2011
Tori Socha
In 1998, the multidetector row computed tomographic pulmonary angiography (CTPA) was introduced, changing the way physicians approach pulmonary embolism (PE). The test was expected to improve outcomes of PE by detecting and allowing treatment...
In 1998, the multidetector row computed tomographic pulmonary angiography (CTPA) was introduced, changing the way physicians approach pulmonary embolism (PE). The test was expected to improve outcomes of PE by detecting and allowing treatment...
In 1998, the multidetector row...
08/23/2011
First Report Managed Care
Leukotriene Receptor Antagonists and Asthma Treatment
08/23/2011
Tori Socha
According to researchers, although double-blind, randomized, controlled trials provide dependable evidence in establishing the efficacy of therapeutic interventions, such proof does not guarantee the effectiveness of a particular therapy in a...
According to researchers, although double-blind, randomized, controlled trials provide dependable evidence in establishing the efficacy of therapeutic interventions, such proof does not guarantee the effectiveness of a particular therapy in a...
According to researchers,...
08/23/2011
First Report Managed Care
Watchful Waiting versus Radical Prostatectomy in Early Prostate Cancer
08/23/2011
Tori Socha
In 2008, study results demonstrated that compared with watchful waiting, radical prostatectomy decreased the risk of metastases, the rate of death from prostate cancer, and the rate of death from any cause. Although the participants in the...
In 2008, study results demonstrated that compared with watchful waiting, radical prostatectomy decreased the risk of metastases, the rate of death from prostate cancer, and the rate of death from any cause. Although the participants in the...
In 2008, study results...
08/23/2011
First Report Managed Care
Prevention of COPD with Tiotropium or Salmeterol
08/23/2011
Tori Socha
Patients with exacerbations of chronic obstructive pulmonary disease (COPD) may be experiencing instability or worsening of their disease. Worldwide, COPD is the leading cause of disability and death, and exacerbations have been associated...
Patients with exacerbations of chronic obstructive pulmonary disease (COPD) may be experiencing instability or worsening of their disease. Worldwide, COPD is the leading cause of disability and death, and exacerbations have been associated...
Patients with exacerbations of...
08/23/2011
First Report Managed Care
Atypical Femoral Fractures and Use of Bisphosphonates
08/23/2011
Tori Socha
Among patients with osteoporosis, the use of bisphosphonates reduces the overall risk of fracture with long-lasting beneficial effect.
Among patients with osteoporosis, the use of bisphosphonates reduces the overall risk of fracture with long-lasting beneficial effect.
Among patients with...
08/23/2011
First Report Managed Care
Trends in Coronary Revascularization Procedures
08/22/2011
Tori Socha
One of the most common major medical procedures provided by the healthcare system in the United States, coronary revascularization, is performed >1 million times each year. The procedure comprises coronary artery bypass graft (CABG)...
One of the most common major medical procedures provided by the healthcare system in the United States, coronary revascularization, is performed >1 million times each year. The procedure comprises coronary artery bypass graft (CABG)...
One of the most common major...
08/22/2011
First Report Managed Care
Changes to Human Research Regulations
08/22/2011
The US Department of Health and Human Services (DHHS) is considering changing the regulations governing research involving human study participants, according to a July 22, 2011, press release from DHHS. The federal government is considering...
The US Department of Health and Human Services (DHHS) is considering changing the regulations governing research involving human study participants, according to a July 22, 2011, press release from DHHS. The federal government is considering...
The US Department of Health and...
08/22/2011
First Report Managed Care
News Connection
Stricter Barrier Precautions Fail to Lower Incidence of Disease- Resistant Infection
08/22/2011
Christin Melton
Investigators with the STAR*ICU (Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units [ICUs]) trial said it will likely take more than screening, strict hygiene practices, and barrier precautions to...
Investigators with the STAR*ICU (Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units [ICUs]) trial said it will likely take more than screening, strict hygiene practices, and barrier precautions to...
Investigators with the STAR*ICU...
08/22/2011
First Report Managed Care
News Connection
An Analysis of the VA’s Anti-MRSA Efforts
08/22/2011
Kevin L. Carter
Methicillin-resistant Staphylococcus aureus (MRSA) infections are one of the most common causes of disease in the healthcare setting. The most common problems include ventilator-associated pneumonia, bloodstream infection associated with...
Methicillin-resistant Staphylococcus aureus (MRSA) infections are one of the most common causes of disease in the healthcare setting. The most common problems include ventilator-associated pneumonia, bloodstream infection associated with...
Methicillin-resistant...
08/22/2011
First Report Managed Care
Immunologic Fecal Occult Blood Testing Effective Screening Tool for Advanced Colorectal Cancer
08/22/2011
Christin Melton
Chicago—Fecal occult blood testing is routinely used to screen for colorectal cancer (CRC), and multiple methods are available. A team of Italian researchers assessed the effectiveness of immunologic fecal occult blood testing (FIT) at...
Chicago—Fecal occult blood testing is routinely used to screen for colorectal cancer (CRC), and multiple methods are available. A team of Italian researchers assessed the effectiveness of immunologic fecal occult blood testing (FIT) at...
Chicago—Fecal occult blood...
08/22/2011
First Report Managed Care
Continuing Clopidogrel Use Appears Safe in Patients Undergoing Polypectomy
08/22/2011
Christin Melton
Patients taking clopidogrel who underwent elective colonoscopy concluded that the risks with temporarily discontinuing treatment outweigh the risk of bleeding.
Patients taking clopidogrel who underwent elective colonoscopy concluded that the risks with temporarily discontinuing treatment outweigh the risk of bleeding.
Patients taking clopidogrel who...
08/22/2011
First Report Managed Care
Out-of-Pocket Expenses and Cancer Care
08/22/2011
Tim Casey
Chicago—According to survey-based research presented at the ASCO meeting, patients who have health insurance but must pay a portion of their cancer care through out-of-pocket expenses are burdened by a decrease in their standard of living,...
Chicago—According to survey-based research presented at the ASCO meeting, patients who have health insurance but must pay a portion of their cancer care through out-of-pocket expenses are burdened by a decrease in their standard of living,...
Chicago—According to...
08/22/2011
First Report Managed Care
Maintenance Therapy with Pemetrexed Improves Progression-Free Survival in Advanced Lung Cancer
08/22/2011
Tim Casey
Chicago—A randomized, double-blind, placebo-controlled phase 3 trial found that patients with advanced nonsquamous non–small-cell lung cancer (NSCLC) taking pemetrexed continuation maintenance therapy had a significantly improved...
Chicago—A randomized, double-blind, placebo-controlled phase 3 trial found that patients with advanced nonsquamous non–small-cell lung cancer (NSCLC) taking pemetrexed continuation maintenance therapy had a significantly improved...
Chicago—A randomized,...
08/22/2011
First Report Managed Care
Adherence to Oral Oncolytic Prescriptions
08/22/2011
Tim Casey
Chicago—Using a pharmacy claims database, researchers found that one third of patients who began oral oncolytic therapy between May 1, 2007, and March 31, 2009, abandoned their first prescription or delayed filling the prescription. The rate...
Chicago—Using a pharmacy claims database, researchers found that one third of patients who began oral oncolytic therapy between May 1, 2007, and March 31, 2009, abandoned their first prescription or delayed filling the prescription. The rate...
Chicago—Using a pharmacy claims...
08/22/2011
First Report Managed Care
Abiraterone Acetate and Ketoconazole in Prostate Cancer Patients
08/22/2011
Tim Casey
Chicago—A study of patients with progressive metastatic castration-resistant prostate cancer (mCRPC) who had previously used ketoconazole and then took abiraterone acetate showed that the 2 drugs could be used as sequential therapy. The...
Chicago—A study of patients with progressive metastatic castration-resistant prostate cancer (mCRPC) who had previously used ketoconazole and then took abiraterone acetate showed that the 2 drugs could be used as sequential therapy. The...
Chicago—A study of patients with...
08/22/2011
First Report Managed Care
Comparison of Premixed Insulin Analogs and Long-Acting Insulin Analogs
08/22/2011
Tim Casey
San Diego—An analysis of a diabetes simulation model from a US healthcare payer perspective found that patients with type 2 diabetes taking premixed insulin analogs were likely to have increased life expectancy and quality-adjusted life...
San Diego—An analysis of a diabetes simulation model from a US healthcare payer perspective found that patients with type 2 diabetes taking premixed insulin analogs were likely to have increased life expectancy and quality-adjusted life...
San Diego—An analysis of a...
08/22/2011
First Report Managed Care
Linagliptin in Type 2 Diabetes Patients with Hyperglycemia
08/22/2011
Tim Casey
San Diego—A pooled analysis of three phase 3, placebo-controlled, randomized trials found that patients with type 2 diabetes and poor glycemic control who took linagliptin for 24 weeks had a statistically significant reduction in hemoglobin...
San Diego—A pooled analysis of three phase 3, placebo-controlled, randomized trials found that patients with type 2 diabetes and poor glycemic control who took linagliptin for 24 weeks had a statistically significant reduction in hemoglobin...
San Diego—A pooled analysis of...
08/22/2011
First Report Managed Care
Cost Results from Look AHEAD Study
08/22/2011
Tim Casey
San Diego—The annual costs associated with managing patients with type 2 diabetes through a structured lifestyle intervention decreased during a 4-year period, according to results of an ongoing multicenter, randomized controlled trial. Ping...
San Diego—The annual costs associated with managing patients with type 2 diabetes through a structured lifestyle intervention decreased during a 4-year period, according to results of an ongoing multicenter, randomized controlled trial. Ping...
San Diego—The annual costs...
08/22/2011
First Report Managed Care
Substituting Liraglutide for Sitagliptin Is Effective in Patients with Type 2 Diabetes
08/22/2011
Tim Casey
San Diego—Patients with type 2 diabetes who switched from taking sitagliptin to liraglutide showed improvements in glycemic control and weight loss after 26 weeks. In addition, the percentage of patients achieving an ADA target hemoglobin A1c...
San Diego—Patients with type 2 diabetes who switched from taking sitagliptin to liraglutide showed improvements in glycemic control and weight loss after 26 weeks. In addition, the percentage of patients achieving an ADA target hemoglobin A1c...
San Diego—Patients with type 2...
08/22/2011
First Report Managed Care
Lifestyle Interventions Improve Glycemic Control for Patients with Type 2 Diabetes
08/22/2011
Tim Casey
San Diego—Patients with type 2 diabetes who underwent an intensive dietary intervention showed significant improvement in glycemic control compared with those who received normal care. However, among the patients who had the diet...
San Diego—Patients with type 2 diabetes who underwent an intensive dietary intervention showed significant improvement in glycemic control compared with those who received normal care. However, among the patients who had the diet...
San Diego—Patients with type 2...
08/22/2011
First Report Managed Care
Adding Exenatide to Glucose-Lowering Regimens Reduces Heart Failure Risk
08/22/2011
Tim Casey
San Diego—A retrospective analysis of an electronic medical record database found that patients with type 2 diabetes who were receiving a glucose-lowering therapy and then added twice-daily injections of exenatide to their regimen had an...
San Diego—A retrospective analysis of an electronic medical record database found that patients with type 2 diabetes who were receiving a glucose-lowering therapy and then added twice-daily injections of exenatide to their regimen had an...
San Diego—A retrospective...
08/22/2011
First Report Managed Care
FDA Regulation of Drugs, Devices for Diabetes
08/22/2011
Tim Casey
During the ADA meeting, a pharmaceutical industry executive and an FDA official provided their views on the pharmaceutical industry.
During the ADA meeting, a pharmaceutical industry executive and an FDA official provided their views on the pharmaceutical industry.
During the ADA meeting, a...
08/22/2011
First Report Managed Care
Saxagliptin as Add-On Therapy to Insulin in Patients with Type 2 Diabetes
08/22/2011
Tim Casey
San Diego—A phase 3b trial presented in a poster session at the ADA meeting indicated that adult patients with type 2 diabetes who took 5 mg of saxagliptin once daily as an add-on therapy to insulin (with or without metformin) showed greater...
San Diego—A phase 3b trial presented in a poster session at the ADA meeting indicated that adult patients with type 2 diabetes who took 5 mg of saxagliptin once daily as an add-on therapy to insulin (with or without metformin) showed greater...
San Diego—A phase 3b trial...
08/22/2011
First Report Managed Care
Flexible Dose of Insulin Degludec Noninferior to Insulin Glargine
08/22/2011
Tim Casey
San Diego—An open-label, randomized trial found that patients with type 2 diabetes who took insulin degludec in a flexible regimen had similar glycemic control, rates of hypoglycemia, insulin dose, and weight gain compared with patients who...
San Diego—An open-label, randomized trial found that patients with type 2 diabetes who took insulin degludec in a flexible regimen had similar glycemic control, rates of hypoglycemia, insulin dose, and weight gain compared with patients who...
San Diego—An open-label,...
08/22/2011
First Report Managed Care
FDA Review Process and Recalls of Medical Devices
08/22/2011
Tori Socha
In 1938, when the US Congress mandated that medical products had to demonstrate safety and effectiveness, the law applied only to drugs, not medical devices. It was not until 1976 that the US Food and Drug Administration (FDA) was given the...
In 1938, when the US Congress mandated that medical products had to demonstrate safety and effectiveness, the law applied only to drugs, not medical devices. It was not until 1976 that the US Food and Drug Administration (FDA) was given the...
In 1938, when the US Congress...
08/22/2011
First Report Managed Care
Kaiser Commission Reports on States’ Online Processes for Medicaid and CHIP Applications
08/22/2011
Christin Melton
According to a Henry J. Kaiser Family Foundation report from the Kaiser Commission on Medicaid and the Uninsured, states offering a single online application process for Medicaid, the Children’s Health Insurance Program (CHIP), and insurance...
According to a Henry J. Kaiser Family Foundation report from the Kaiser Commission on Medicaid and the Uninsured, states offering a single online application process for Medicaid, the Children’s Health Insurance Program (CHIP), and insurance...
According to a Henry J. Kaiser...
08/22/2011
First Report Managed Care
Perceptions of Benefits and Harms Affect Patient Adherence to Medication Therapies
08/22/2011
Tori Socha
Adherence to evidence-based guidelines for the prevention or management of particular diseases can be influenced by quality-assurance and pay-for-performance initiatives, but patient preference may be at odds with guideline-directed therapy....
Adherence to evidence-based guidelines for the prevention or management of particular diseases can be influenced by quality-assurance and pay-for-performance initiatives, but patient preference may be at odds with guideline-directed therapy....
Adherence to evidence-based...
08/22/2011
First Report Managed Care
Eye-Injury–Related Visits to the Emergency Department
08/22/2011
Tori Socha
There are >2.5 million eye injuries each year in the United States, and 50,000 people permanently lose all or part of their vision.
There are >2.5 million eye injuries each year in the United States, and 50,000 people permanently lose all or part of their vision.
There are >2.5 million eye...
08/22/2011
First Report Managed Care
Primary Care Physician Workforce and Patient Outcomes
08/22/2011
Tori Socha
Most scenarios to improve the outcomes and efficiency of the healthcare system in the United States include strengthening the role of primary care. Due to a decreasing interest in primary care among graduates of US medical schools, there are...
Most scenarios to improve the outcomes and efficiency of the healthcare system in the United States include strengthening the role of primary care. Due to a decreasing interest in primary care among graduates of US medical schools, there are...
Most scenarios to improve the...
08/22/2011
First Report Managed Care
Associations between Patient Expectations and Recovery Outcomes
08/22/2011
Tori Socha
Physical and social functioning following serious illness has been shown to correlate with patient expectations for recovery. However, evidence showing the impact of expectations on clinical outcomes is limited. Prior studies have examined...
Physical and social functioning following serious illness has been shown to correlate with patient expectations for recovery. However, evidence showing the impact of expectations on clinical outcomes is limited. Prior studies have examined...
Physical and social functioning...
08/22/2011
First Report Managed Care
News Connection
Five Years of Follow-Up of Patients with Acute Respiratory Distress Syndrome
08/22/2011
Tori Socha
The acute respiratory distress syndrome (ARDS) is, according to researchers, “an important and costly public health problem.” There have been few studies designed to obtain extensive, longitudinal data from survivors of ARDS in regard to...
The acute respiratory distress syndrome (ARDS) is, according to researchers, “an important and costly public health problem.” There have been few studies designed to obtain extensive, longitudinal data from survivors of ARDS in regard to...
The acute respiratory distress...
08/22/2011
First Report Managed Care
Preventive Services Covered by Medicare under Affordable Care Act
08/22/2011
Tori Socha
As of January 1, 2011, Americans covered by Medicare were able to begin taking advantage of benefits and savings available through the Affordable Care Act. 
As of January 1, 2011, Americans covered by Medicare were able to begin taking advantage of benefits and savings available through the Affordable Care Act. 
As of January 1, 2011, Americans...
08/22/2011
First Report Managed Care
Comparative Efficacy Data and Drug Approval in the United States
08/22/2011
Tori Socha
The 2009 American Recovery and Reinvestment Act included an allocation of $1.1 billion for comparative effectiveness research (CER). The Institute of Medicine defines CER as the “generation and synthesis of evidence that compares the benefits...
The 2009 American Recovery and Reinvestment Act included an allocation of $1.1 billion for comparative effectiveness research (CER). The Institute of Medicine defines CER as the “generation and synthesis of evidence that compares the benefits...
The 2009 American Recovery and...
08/22/2011
First Report Managed Care
AMA Reports on Health Insurers’ Claims Accuracy
08/22/2011
Tim Casey
Results from a recent survey found that the 7 largest health insurers in the United States significantly reduced their claim denial rates and improved their transparency and accuracy of contracted rates. However, they had an average claims...
Results from a recent survey found that the 7 largest health insurers in the United States significantly reduced their claim denial rates and improved their transparency and accuracy of contracted rates. However, they had an average claims...
Results from a recent survey...
08/22/2011
First Report Managed Care
DHHS Announces Proposed Rules for State Health Insurance Exchanges
08/22/2011
Tim Casey
The Department of Health and Human Services (DHHS) released proposed rules for health insurance Exchanges, considered an integral part of the Patient Protection and ACA. 
The Department of Health and Human Services (DHHS) released proposed rules for health insurance Exchanges, considered an integral part of the Patient Protection and ACA. 
The Department of Health and...
08/22/2011
First Report Managed Care

Pipeline Projections

PIPELINE PROJECTIONS
Emerging Therapies Reshaping Atopic Dermatitis Care
03/26/2026
Roy Moore
Roy Moore outlines how a rapidly expanding atopic dermatitis pipeline is intensifying competition, reshaping payer strategies, and raising the bar for new therapies.
Roy Moore outlines how a rapidly expanding atopic dermatitis pipeline is intensifying competition, reshaping payer strategies, and raising the bar for new therapies.
Roy Moore outlines how a rapidly...
03/26/2026
First Report Managed Care
Pipe
Pipeline Projections
Emerging Migraine Treatments Challenge a Mature Market
11/20/2025
Roy Moore
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market...
11/20/2025
First Report Managed Care
Pipeline Projections
Pipeline Projections
Redefining Asthma Management With Emerging Anti-Inflammatories
10/01/2025
Roy Moore
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access...
10/01/2025
First Report Managed Care
Pipeline Projections
The Shift in MS Care as Biologics and BTK Inhibitors Advance
07/25/2025
Roy Moore
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline...
07/25/2025
First Report Managed Care
Pipeline Projections
How Biosimilars Are Shaping RA Treatment and Reimbursement Strategies
04/29/2025
Roy Moore
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline...
04/29/2025
First Report Managed Care

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Behind the Bill

Behind the Bill
HHS Hits Reset on 340B Rebate Model After Court Setbacks
02/11/2026
Juliet Gallagher
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and...
02/11/2026
First Report Managed Care
Behind the Bill
Funding Package Extends Medicare Telehealth, Enacts PBM Reforms, and Updates Hospital Oversight
02/05/2026
Juliet Gallagher
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President...
02/05/2026
First Report Managed Care
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

August 2011 Volume 8 Issue 8

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