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August 2017 - FRMC

Formulary Frontlines®
Formulary Update on Osteoporosis in Men and Postmenopausal Women
02/10/2018
Kyle Schweser, MD; Brett Crist, MD
Kyle Schweser, MD, and Brett Crist, MD, discuss the numerous treatment options and recommendations that are currently available for osteoporosis in men and postmenopausal women. 
Kyle Schweser, MD, and Brett Crist, MD, discuss the numerous treatment options and recommendations that are currently available for osteoporosis in men and postmenopausal women. 
Kyle Schweser, MD, and Brett...
02/10/2018
First Report Managed Care
Managed Care Innovator: TJ Parker, PharmD - Part 2
09/03/2017
David Costill
In Part 2 of our in-depthy interview, TJ Parker, PharmD, explains why PillPack may interest payers or pharmacy benefit managers.
In Part 2 of our in-depthy interview, TJ Parker, PharmD, explains why PillPack may interest payers or pharmacy benefit managers.
In Part 2 of our in-depthy...
09/03/2017
First Report Managed Care
Managed Care Innovator: TJ Parker, PharmD - Part 1
08/30/2017
David Costill
TJ Parker, PharmD co-founder and CEO of PillPack discusses how his company could change the way the country receives and takes their medications—all while reducing costs and improving adherence
TJ Parker, PharmD co-founder and CEO of PillPack discusses how his company could change the way the country receives and takes their medications—all while reducing costs and improving adherence
TJ Parker, PharmD co-founder and...
08/30/2017
First Report Managed Care
Conference Insider
Managing Adult Patients With Atopic Dermatitis
08/30/2017
During a session at the 2017 American Academy of Dermatology Annual Summer Meeting, Jonathan I Silverberg, MD, PhD, MPH, discussed how atopic dermatitis impacts adult patients and the latest treatment options for effective eczema management.
During a session at the 2017 American Academy of Dermatology Annual Summer Meeting, Jonathan I Silverberg, MD, PhD, MPH, discussed how atopic dermatitis impacts adult patients and the latest treatment options for effective eczema management.
During a session at the 2017...
08/30/2017
First Report Managed Care
Conference Insider
Report: Skin Disease Accounts for $75 Billion Annually
08/30/2017
According to a report presented at the 2017 American Academy of Dermatology (AAD) Annual Summer Meeting, the annual burden of skin disease was $75 billion in 2013, with an average per patient cost of $887.
According to a report presented at the 2017 American Academy of Dermatology (AAD) Annual Summer Meeting, the annual burden of skin disease was $75 billion in 2013, with an average per patient cost of $887.
According to a report presented...
08/30/2017
First Report Managed Care
Conference Insider
Cellular Therapy May Effectively Treats Skin Diseases
08/30/2017
An emerging cancer treatment, known as adoptive cellular therapy, shows promise for treating skin diseases like the autoimmune disease pemphigus vulgaris, according to recent research presented at the 2017 American Academy of Dermatology...
An emerging cancer treatment, known as adoptive cellular therapy, shows promise for treating skin diseases like the autoimmune disease pemphigus vulgaris, according to recent research presented at the 2017 American Academy of Dermatology...
An emerging cancer treatment,...
08/30/2017
First Report Managed Care
Conference Insider
AMA Offers Solutions for VA Access Issues
08/30/2017
During a panel discussion at the 2017 American Medical Association (AMA) Annual Meeting, panelists discussed solutions and reiterated the AMA’s commitment to improving quality of care and access to care for veterans.
During a panel discussion at the 2017 American Medical Association (AMA) Annual Meeting, panelists discussed solutions and reiterated the AMA’s commitment to improving quality of care and access to care for veterans.
During a panel discussion at the...
08/30/2017
First Report Managed Care
Conference Insider
Policy Supports Easing Burden of Out-Of-Network Care
08/30/2017
During the 2017 American Medical Association (AMA) Annual Meeting, a panel discussed the need for policies to support patients with serious conditions who switch health plans while receiving care for serious conditions, chronic conditions, or...
During the 2017 American Medical Association (AMA) Annual Meeting, a panel discussed the need for policies to support patients with serious conditions who switch health plans while receiving care for serious conditions, chronic conditions, or...
During the 2017 American Medical...
08/30/2017
First Report Managed Care
Conference Insider
Convenience of Retail Clinics Should Not Fragment Care
08/30/2017
Recommendations for retail health clinics were discussed at the 2017 American Medical Association (AMA) Annual Meeting, including the need for clinics to establish continuity of care and support patients in finding primary care providers.
Recommendations for retail health clinics were discussed at the 2017 American Medical Association (AMA) Annual Meeting, including the need for clinics to establish continuity of care and support patients in finding primary care providers.
Recommendations for retail...
08/30/2017
First Report Managed Care
Conference Insider
Neurologist Shortage Throughout the United States
08/30/2017
According to data presented at the AAIC 2017, a severe shortage of neurologists is currently affecting several regions throughout the United States and could cause significant issues as Alzheimers disease and other dementia-related disease...
According to data presented at the AAIC 2017, a severe shortage of neurologists is currently affecting several regions throughout the United States and could cause significant issues as Alzheimers disease and other dementia-related disease...
According to data presented at...
08/30/2017
First Report Managed Care
Conference Insider
One-Third of Dementia May Be Preventable
08/30/2017
A significant proportion of dementia cases could be prevented by addressing lifestyle factors that increase risk, according to a recent report presented at the AAIC 2017.
A significant proportion of dementia cases could be prevented by addressing lifestyle factors that increase risk, according to a recent report presented at the AAIC 2017.
A significant proportion of...
08/30/2017
First Report Managed Care
Conference Insider
Underutilization of PET Scans Increases Alzheimers Care Costs
08/30/2017
Two studies presented at AAIC 2017 showed that utilization of amyloid-beta PET scans allows for more accurate diagnosis of Alzheimer’s disease, avoiding wasted costs associated with misdiagnosis or delayed diagnosis. 
Two studies presented at AAIC 2017 showed that utilization of amyloid-beta PET scans allows for more accurate diagnosis of Alzheimer’s disease, avoiding wasted costs associated with misdiagnosis or delayed diagnosis. 
Two studies presented at AAIC...
08/30/2017
First Report Managed Care
News Connection
Maryland Law Will Criminalize Unethical Price Gouging
08/30/2017
In an editorial published in the New England Journal of Medicine, Jeremy A Greene, MD, PhD, professor of medicine at the Johns Hopkins University School of Medicine, and William V Padula, PhD, assistant professor at the Johns Hopkins...
In an editorial published in the New England Journal of Medicine, Jeremy A Greene, MD, PhD, professor of medicine at the Johns Hopkins University School of Medicine, and William V Padula, PhD, assistant professor at the Johns Hopkins...
In an editorial published in the...
08/30/2017
First Report Managed Care
News Connection
Louisiana to Request Federal Intervention to Bring Down HCV Treatment Costs
08/30/2017
Louisiana’s Secretary of the Department of Health, Rebekah Gee, MD, MPH, recently suggested that she will ask the federal government to intervene to reduce the cost of hepatitis C treatment in the state, according to a recent Washington Post...
Louisiana’s Secretary of the Department of Health, Rebekah Gee, MD, MPH, recently suggested that she will ask the federal government to intervene to reduce the cost of hepatitis C treatment in the state, according to a recent Washington Post...
Louisiana’s Secretary of the...
08/30/2017
First Report Managed Care
News Connection
CMS Proposed Rule Cuts 340B Payments
08/30/2017
The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to cut Agency payments to hospitals under the program. 
The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to cut Agency payments to hospitals under the program. 
The Centers for Medicare &...
08/30/2017
First Report Managed Care
News Connection
CMS to Start $43 Billion in Disproportionate Share Hospital Payment Cuts
08/30/2017
The CMS recently proposed a rule that would cut $43 billion in Disproportionate Share Hospital (DSH) payments to hospitals between 2018 and 2025, according to a recent Federal Register notice.
The CMS recently proposed a rule that would cut $43 billion in Disproportionate Share Hospital (DSH) payments to hospitals between 2018 and 2025, according to a recent Federal Register notice.
The CMS recently proposed a rule...
08/30/2017
First Report Managed Care
News Connection
Ohio Works With Insurers to Fill 2018 ACA Marketplace Gaps
08/30/2017
The Ohio Department of Insurance announced today that it restored coverage in the 19 state counties that had no ACA marketplace insurers for 2018.
The Ohio Department of Insurance announced today that it restored coverage in the 19 state counties that had no ACA marketplace insurers for 2018.
The Ohio Department of Insurance...
08/30/2017
First Report Managed Care
News Connection
Medicare Shared Savings Program Fails to Improve Diabetes Adherence
08/30/2017
The Medicare Shared Savings Program failed to improve medication use or increase adherence among patients with cardiovascular disease or diabetes, according to a recent study in JAMA Cardiology. 
The Medicare Shared Savings Program failed to improve medication use or increase adherence among patients with cardiovascular disease or diabetes, according to a recent study in JAMA Cardiology. 
The Medicare Shared Savings...
08/30/2017
First Report Managed Care
News Connection
TAVR Prices Increase as SAVR gets Cheaper
08/30/2017
Recent research in JAMA Surgery showed that the adjusted-upfront costs of transcatheter aortic valve replacement (TAVR) are increasing, while the costs of surgical aortic valve replacement (SAVR) are decreasing. 
Recent research in JAMA Surgery showed that the adjusted-upfront costs of transcatheter aortic valve replacement (TAVR) are increasing, while the costs of surgical aortic valve replacement (SAVR) are decreasing. 
Recent research in JAMA Surgery...
08/30/2017
First Report Managed Care
News Connection
Express Scripts Formulary Excludes 64 New Drugs
08/30/2017
Express Scripts recently announced the 2018 National Preferred Formulary, which excludes 64 new medications in order to improve value-based outcomes.  
Express Scripts recently announced the 2018 National Preferred Formulary, which excludes 64 new medications in order to improve value-based outcomes.  
Express Scripts recently...
08/30/2017
First Report Managed Care
Department
A Hard Look at the Cost of Cancer Therapy
08/30/2017
Russell J. Spjut, PharmD
With limited success and skyrocketing costs, it could be time for the United States to take a hard look at the societal impact of current cancer therapy coverage practices. Countries like the United Kingdom and Sweden could provide a starting...
With limited success and skyrocketing costs, it could be time for the United States to take a hard look at the societal impact of current cancer therapy coverage practices. Countries like the United Kingdom and Sweden could provide a starting...
With limited success and...
08/30/2017
First Report Managed Care
Managed Care Q&A
Improving Population Health Management to Achieve the Triple Aim
08/30/2017
David Costill
Virginia Gurley, MD, chief medical officer at AxisPoint Health, discusses population health strategies that payers can employ to achieve the Triple Aim of improving health outcomes while reducing costs.
Virginia Gurley, MD, chief medical officer at AxisPoint Health, discusses population health strategies that payers can employ to achieve the Triple Aim of improving health outcomes while reducing costs.
Virginia Gurley, MD, chief...
08/30/2017
First Report Managed Care
How Do Direct-to-Consumer Ads Impact Payers?
08/25/2017
Paul Nicolaus
A recent push by the AMA to ban all forms of direct-to-consumer advertising for pharmaceutical products is beginning to pick up steam—but should payers beconcerned with how advertising impacts costs?
A recent push by the AMA to ban all forms of direct-to-consumer advertising for pharmaceutical products is beginning to pick up steam—but should payers beconcerned with how advertising impacts costs?
A recent push by the AMA to ban...
08/25/2017
First Report Managed Care
Policy & Politics: Can Reinsurance Programs Save the ACA?
08/11/2017
Dean Celia
Alaska had little choice but to fund its own reinsurance effort to stem the tide of skyrocketing premiums. It worked so well that the federal government will now fund the program. But will this work for other states, and if not, what will...
Alaska had little choice but to fund its own reinsurance effort to stem the tide of skyrocketing premiums. It worked so well that the federal government will now fund the program. But will this work for other states, and if not, what will...
Alaska had little choice but to...
08/11/2017
First Report Managed Care
News
ICER: Does the Industry Take Cost-Effectiveness Seriously?
08/04/2017
Eileen Koutnik-Fotopoulos
As drug prices climb, the Institute for Clinical and Economic Review continues to sound the cost-effectiveness alarm—but are payers listening? Managed care experts dig into how ICER reports could be utilized to bring down drug prices and...
As drug prices climb, the Institute for Clinical and Economic Review continues to sound the cost-effectiveness alarm—but are payers listening? Managed care experts dig into how ICER reports could be utilized to bring down drug prices and...
As drug prices climb, the...
08/04/2017
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

Trending Articles

Feature Story
A Better Way to Pay for Primary Care
05/31/2024
Mary Beth Nierengarten
A push for a hybrid payment model for primary care is gaining momentum, with advocates urging the CMS to implement changes to increase funding and improve outcomes for patients.
A push for a hybrid payment model for primary care is gaining momentum, with advocates urging the CMS to implement changes to increase funding and improve outcomes for patients.
A push for a hybrid payment...
05/31/2024
First Report Managed Care
Conference Coverage
Mepolizumab Treatment May Reduce Health Care Resource Utilization and OCS in Patients With CRSwNP
04/10/2024
Hannah Musick
Research that will be presented at AMCP 2024 suggests that mepolizumab treatment reduces health care costs and resource utilization in patients with chronic rhinosinusitis with nasal polyps.
Research that will be presented at AMCP 2024 suggests that mepolizumab treatment reduces health care costs and resource utilization in patients with chronic rhinosinusitis with nasal polyps.
Research that will be presented...
04/10/2024
First Report Managed Care
News
Keratoconus Appears to be Associated With Demodex Mites
05/16/2024
Jolynn Tumolo
Keratoconus, an eye disorder that leads to gradual curvature of the cornea, may be associated with Demodex infestation, suggests a small study published in the Oman Journal of Ophthalmology.
Keratoconus, an eye disorder that leads to gradual curvature of the cornea, may be associated with Demodex infestation, suggests a small study published in the Oman Journal of Ophthalmology.
Keratoconus, an eye disorder...
05/16/2024
First Report Managed Care
Alison Lum Headshot
Interview
Transforming Pharmacy Care and Drug Payment Models: Expert Insights From Asembia 2024
06/06/2024
Alison Lum, PharmD
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum,...
06/06/2024
First Report Managed Care
Ashley Joseph
Conference Coverage
The Impact of AI on Infusion Patient Care and Operational Efficiency
07/22/2024
Ashley Joseph
NICA 2024 session speaker Ashley Joseph of LeanTaas shares insights on how AI technologies are revolutionizing infusion therapy operations, improving care coordination, and ultimately enhancing the patient experience in these critical care...
NICA 2024 session speaker Ashley Joseph of LeanTaas shares insights on how AI technologies are revolutionizing infusion therapy operations, improving care coordination, and ultimately enhancing the patient experience in these critical care...
NICA 2024 session speaker Ashley...
07/22/2024
First Report Managed Care

August 2017 Volume 14 Issue 8

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