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December 2015 - FRMC

January 2016 Issue Preview (Conference Insider)
12/20/2015
First Report Managed Care continues to be dedicated to providing important coverage of conferences affecting managed care professionals.
First Report Managed Care continues to be dedicated to providing important coverage of conferences affecting managed care professionals.
First Report Managed...
12/20/2015
First Report Managed Care
Disease State Overview: Hyperkalemia, A Serious Condition With Limited Treatments
12/18/2015
Managing hyperkalemia is complex and current options are limited; new therapies may address treatment gap.
Managing hyperkalemia is complex and current options are limited; new therapies may address treatment gap.
Managing hyperkalemia is complex...
12/18/2015
First Report Managed Care
Treatment Innovations: New Treatment Options for Asthma-Albuterol sulfate
12/18/2015
This breath-actuated, multidose, dry powder, short-acting beta-agonist inhaler is the first and only of its kind.  
This breath-actuated, multidose, dry powder, short-acting beta-agonist inhaler is the first and only of its kind.  
This breath-actuated, multidose,...
12/18/2015
First Report Managed Care
Department
Treatment Innovations: New Treatment Options for Asthma- albuterol sulfate
12/18/2015
Treatment Innovations: New Treatment Options for Asthma- albuterol sulfate This breath-actuated, multidose, dry powder, short-acting beta-agonist inhaler is the first and only of its kind. This First Report Managed Care Treatment...
Treatment Innovations: New Treatment Options for Asthma- albuterol sulfate This breath-actuated, multidose, dry powder, short-acting beta-agonist inhaler is the first and only of its kind. This First Report Managed Care Treatment...
Treatment Innovations: New...
12/18/2015
First Report Managed Care
Money and Politics: Challenges of Voting on a Single-payer System
12/18/2015
Mary Beth Nierengarten
Colorado will need to navigate a possible divisive political environment while securing the necessary funds—including a proposed 10% payroll tax hike.
Colorado will need to navigate a possible divisive political environment while securing the necessary funds—including a proposed 10% payroll tax hike.
Colorado will need to navigate a...
12/18/2015
First Report Managed Care
January 2016 Issue Preview (features)
12/18/2015
The following topics will be featured in the January 2016 issue of First Report Managed Care.    Hello, Goodbye: The implications of UnitedHealth Group’s potentially brief participation in the exchanges Is this problem with the Affordable...
The following topics will be featured in the January 2016 issue of First Report Managed Care.    Hello, Goodbye: The implications of UnitedHealth Group’s potentially brief participation in the exchanges Is this problem with the Affordable...
The following topics will be...
12/18/2015
First Report Managed Care
Literature Review: Managing Asthma
12/18/2015
Literature Review: Managing Asthma: A Challenge for Stakeholders   Asthma is a chronic disease that causes inflammation in the airways of the lungs, with multifactorial pathophysiology.1 According to the Centers for Disease Control and...
Literature Review: Managing Asthma: A Challenge for Stakeholders   Asthma is a chronic disease that causes inflammation in the airways of the lungs, with multifactorial pathophysiology.1 According to the Centers for Disease Control and...
Literature Review: Managing...
12/18/2015
First Report Managed Care
News
ACR: High Cost of Rheumatoid Arthritis in the Elderly
12/18/2015
Elderly patients with rheumatoid arthritis (RA) have significantly greater comorbidities, health care resource utilization (HCRU), and cost compared to those without.
Elderly patients with rheumatoid arthritis (RA) have significantly greater comorbidities, health care resource utilization (HCRU), and cost compared to those without.
Elderly patients with rheumatoid...
12/18/2015
First Report Managed Care
GOP Candidates and Health Spending: Our Experts Pull Back the Curtain
12/18/2015
Dean Celia
The Republicans have yet to reveal many specifics, but as they slug it out for the nomination, all want to repeal the ACA.
The Republicans have yet to reveal many specifics, but as they slug it out for the nomination, all want to repeal the ACA.
The Republicans have yet to...
12/18/2015
First Report Managed Care
Conference Insider
AMCP: Looking at the Evidence: Studies Shed Light on Issues Affecting Managed Care
12/18/2015
In a session entitled “Research and Evidence Podium” at the AMCP Nexus meeting, a panel of experts discussed data from several studies that shed light on a number of issues affecting managed care.
In a session entitled “Research and Evidence Podium” at the AMCP Nexus meeting, a panel of experts discussed data from several studies that shed light on a number of issues affecting managed care.
In a session entitled “Research...
12/18/2015
First Report Managed Care
Conference Insider
AMCP: Performance-based Risk-sharing Agreement Data Benefits Payers and Drug Makers
12/18/2015
  The development and launch of a new drug is filled with uncertainty. Historically, the pharmaceuti­cal manufacturer has no guarantee of success when investing in research and development, so, upon launch, it tends to seek the highest...
  The development and launch of a new drug is filled with uncertainty. Historically, the pharmaceuti­cal manufacturer has no guarantee of success when investing in research and development, so, upon launch, it tends to seek the highest...
  The development and launch of...
12/18/2015
First Report Managed Care
Conference Insider
AMCP: Improving Adherence Means More Than Just Information
12/18/2015
The effects of treatment nonadherence are serious and include poor clinical outcomes, higher mortality, and increased costs and stress on the health care system.
The effects of treatment nonadherence are serious and include poor clinical outcomes, higher mortality, and increased costs and stress on the health care system.
The effects of treatment...
12/18/2015
First Report Managed Care
AMCP: Improving Quality Measures Through Pharmacy Pay-for-Performance Programs
12/18/2015
 
 
 
12/18/2015
First Report Managed Care
Conference Insider
AMCP: Innovative Care Delivery Options Can Reduce Health Care Costs
12/18/2015
Two care delivery models (accountable care organizations (ACOs) and a specialty pharmacy integrated delivery system) were discussed at an AMCP Nexus session.
Two care delivery models (accountable care organizations (ACOs) and a specialty pharmacy integrated delivery system) were discussed at an AMCP Nexus session.
Two care delivery models...
12/18/2015
First Report Managed Care
Are all Co-ops Really Doomed to Fail?
12/18/2015
Paul Nicolaus
Are all Co-ops Really Doomed to Fail? Intended to serve as alternatives to the policies offered by for-profit insurers, the nonprofit health insurance co-ops created under the Affordable Care Act have been failing at an alarming rate.  
Are all Co-ops Really Doomed to Fail? Intended to serve as alternatives to the policies offered by for-profit insurers, the nonprofit health insurance co-ops created under the Affordable Care Act have been failing at an alarming rate.  
Are all Co-ops Really Doomed to...
12/18/2015
First Report Managed Care
Conference Insider
PCMH: MCO Demonstrates Characteristics of an Advanced Patient-centered Medical Home Model
12/18/2015
  A Colorado managed care organization, Rocky Mountain Health Plans (RMHP), aligns clini­cal decision-making through advanced analytics, behavioral health integration, data quality, and improved process, said Patrick Gordon, MPA, as­sociate...
  A Colorado managed care organization, Rocky Mountain Health Plans (RMHP), aligns clini­cal decision-making through advanced analytics, behavioral health integration, data quality, and improved process, said Patrick Gordon, MPA, as­sociate...
  A Colorado managed care...
12/18/2015
First Report Managed Care
Time for the Pharmaceutical Industry to Make its Side Heard
12/18/2015
Kelsey Moroz; Lisa A. Tomaszewski, PhD
Time for the Pharmaceutical Industry to Make its Side Heard Experts defend the worth of the pharmaceutical industry, arguing drug cost is not the greatest challenge to health care spending.  
Time for the Pharmaceutical Industry to Make its Side Heard Experts defend the worth of the pharmaceutical industry, arguing drug cost is not the greatest challenge to health care spending.  
Time for the Pharmaceutical...
12/18/2015
First Report Managed Care
Conference Insider
NASP: Use of Biologics in Psoriasis Patients Increases Health Care Costs
12/18/2015
Total health care costs associated with the use of biologic therapy on patients with psoriasis increased significantly from 2008 to 2013 according to a poster at the 2015 NASP Annual Conference that evaluated cost trends from a US managed...
Total health care costs associated with the use of biologic therapy on patients with psoriasis increased significantly from 2008 to 2013 according to a poster at the 2015 NASP Annual Conference that evaluated cost trends from a US managed...
Total health care costs...
12/18/2015
First Report Managed Care
NASP: As RA Specialty Drug Use Rises, Technology and Collaboration Will Be Key to Management
12/18/2015
  By 2018, the sale of specialty drugs is expected to surpass the sales of traditional agents. Inflammatory disease, including rheumatoid ar­thritis (RA), is the most expensive specialty category under the pharmacy benefit, Jeffrey Dunn,...
  By 2018, the sale of specialty drugs is expected to surpass the sales of traditional agents. Inflammatory disease, including rheumatoid ar­thritis (RA), is the most expensive specialty category under the pharmacy benefit, Jeffrey Dunn,...
  By 2018, the sale of...
12/18/2015
First Report Managed Care
Conference Insider
NASP: Clinical Therapy Management Program Impact on Adherence
12/18/2015
  Implementing a clinical therapy management (CTM) program can have a significant impact on adherence, according to a study involving 178 patients who had at least 1 prescription dispensed for immune globulin (IG) therapy. The study results...
  Implementing a clinical therapy management (CTM) program can have a significant impact on adherence, according to a study involving 178 patients who had at least 1 prescription dispensed for immune globulin (IG) therapy. The study results...
  Implementing a clinical...
12/18/2015
First Report Managed Care
Conference Insider
NASP: Affordable, Quality Cancer Care Will Rely on the Use of Pathways
12/18/2015
  Future cancer care will depend on the use of pathways in order to achieve a goal of acces­sible, affordable high-quality care, according to information presented by industry leaders at the 2015 NASP Annual Conference. The cost of cancer...
  Future cancer care will depend on the use of pathways in order to achieve a goal of acces­sible, affordable high-quality care, according to information presented by industry leaders at the 2015 NASP Annual Conference. The cost of cancer...
  Future cancer care will...
12/18/2015
First Report Managed Care
How to Adapt as Clinical Pathways Change Managed Care
12/18/2015
Dean Celia
How to Adapt as Clinical Pathways Change Managed Care   As more and more costly medications are being pushed through the drug development pipe­line, clinical pathways are being viewed as a tool for managed care executives and practitioners...
How to Adapt as Clinical Pathways Change Managed Care   As more and more costly medications are being pushed through the drug development pipe­line, clinical pathways are being viewed as a tool for managed care executives and practitioners...
How to Adapt as Clinical...
12/18/2015
First Report Managed Care
News Connection
News Connection - December 2015
12/18/2015
Interleukin-6 Plays Pivotal Role in Pathophysiology of RA Rheumatoid arthritis (RA), estimated to affect at least 1.3 million Americans, is a chronic systemic disease resulting in pain, stiffness, swell-ing, and function of joints.1...
Interleukin-6 Plays Pivotal Role in Pathophysiology of RA Rheumatoid arthritis (RA), estimated to affect at least 1.3 million Americans, is a chronic systemic disease resulting in pain, stiffness, swell-ing, and function of joints.1...
Interleukin-6 Plays Pivotal Role...
12/18/2015
First Report Managed Care
Department
News Connection- December 2015
12/18/2015
Rheumatoid arthritis (RA) is a chronic systemic disease resulting in pain, stiffness, swell-ing, and function of joints.
Rheumatoid arthritis (RA) is a chronic systemic disease resulting in pain, stiffness, swell-ing, and function of joints.
Rheumatoid arthritis (RA) is a...
12/18/2015
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

Steve Vacarro
Interview
The Role of Electronic Visit Verification in Enhancing Quality, Efficiency, and Medicaid Integrity
02/29/2024

Featuring Stephen Vaccaro, president, HHAeXchange

Featuring Stephen Vaccaro, president,...
In this interview, an expert discusses the importance of Electronic Visit Verification (EVV) in homecare services. EVV ensures accurate documentation of homecare visits, leading to improved patient outcomes and quality of care. Medicaid has a...
In this interview, an expert discusses the importance of Electronic Visit Verification (EVV) in homecare services. EVV ensures accurate documentation of homecare visits, leading to improved patient outcomes and quality of care. Medicaid has a...
In this interview, an expert...
02/29/2024
First Report Managed Care
News
From Indolent to Aggressive: Understanding Lymphoma Transformation
04/09/2024
Hannah Musick
“Histologic transformation of indolent lymphoma to aggressive lymphoma, most commonly DLBCL, represents a well-recognized event,” said researchers. “While work in the past decade has shed light on many of the genetic and biological changes of...
“Histologic transformation of indolent lymphoma to aggressive lymphoma, most commonly DLBCL, represents a well-recognized event,” said researchers. “While work in the past decade has shed light on many of the genetic and biological changes of...
“Histologic transformation of...
04/09/2024
First Report Managed Care
News
Hospital Costs May Be Higher for Patients With Private Insurance
05/14/2024
Hannah Musick
A recent research report reveals that individuals with private health insurance pay 254% more for hospital procedures than Medicare rates, leading to potentially increased costs for millions of Americans.
A recent research report reveals that individuals with private health insurance pay 254% more for hospital procedures than Medicare rates, leading to potentially increased costs for millions of Americans.
A recent research report reveals...
05/14/2024
First Report Managed Care
News
Fitusiran Prophylaxis Shows Promise for Protection Against Bleeding for Patients With Hemophilia A or B
06/05/2024
Grace Taylor, MS, MA
A phase 3 study evaluated the efficacy and safety of fitusiran in males with hemophilia A or B who were receiving bypassing agent (BPA)/clotting factor concentrate (CFC) prophylaxis.
A phase 3 study evaluated the efficacy and safety of fitusiran in males with hemophilia A or B who were receiving bypassing agent (BPA)/clotting factor concentrate (CFC) prophylaxis.
A phase 3 study evaluated the...
06/05/2024
First Report Managed Care
Infographic
The Efficacy and Safety of an Oral Phosphodiesterase 4B (PDE4B) Inhibitor, BI 1015550, in Patients With Idiopathic Pulmonary Fibrosis (IPF): A Phase 2 Clinical Trial
07/24/2024
This infographic summarizes a recent Phase 2 clinical trial evaluating the efficacy and safety of an oral phosphodiesterase inhibitor in patients with idiopathic pulmonary fibrosis (IPF).
This infographic summarizes a recent Phase 2 clinical trial evaluating the efficacy and safety of an oral phosphodiesterase inhibitor in patients with idiopathic pulmonary fibrosis (IPF).
This infographic summarizes a...
07/24/2024
First Report Managed Care

December 2015 Volume 12 Issue 12

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