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January 2018 - FRMC

Conference Highlights
PCMH Key to Successful Population Health Management
01/29/2018
A presentation at the PCMH Congress 2017 highlighted how quality evidence-based care models like the patient-centered medical home model (PCMH) and better policies that support small practices in underserved communities are the keys to...
A presentation at the PCMH Congress 2017 highlighted how quality evidence-based care models like the patient-centered medical home model (PCMH) and better policies that support small practices in underserved communities are the keys to...
A presentation at the PCMH...
01/29/2018
First Report Managed Care
Conference Insider
Patient-Centered Oncology Care Model Improves Quality Measures
01/29/2018
During a presentation at the PCMH Congress 2017, Kashyap Patel, MD, an oncologist at Carolina Blood and Cancer Care; Patricia Barrett, MHSA, vice president of product design and support at the NCQA; and Manasi Tirodkar, PhD, MS, a research...
During a presentation at the PCMH Congress 2017, Kashyap Patel, MD, an oncologist at Carolina Blood and Cancer Care; Patricia Barrett, MHSA, vice president of product design and support at the NCQA; and Manasi Tirodkar, PhD, MS, a research...
During a presentation at the...
01/29/2018
First Report Managed Care
Conference Insider
Insurance Status Associated With Varying Survival Outcomes in Lymphoma
01/29/2018
According to a presentation at the ASH 2017 Annual Meeting & Exposition, insurance status heavily influenced treatment and survival outcomes among patients with Burkitt lymphoma (BL), but not patients with plasmablastic lymphoma (PBL).
According to a presentation at the ASH 2017 Annual Meeting & Exposition, insurance status heavily influenced treatment and survival outcomes among patients with Burkitt lymphoma (BL), but not patients with plasmablastic lymphoma (PBL).
According to a presentation at...
01/29/2018
First Report Managed Care
Conference Insider
Older AML Patients Experience High Cost Burdens
01/29/2018
Elderly patients with acute myeloid leukemia (AML) faced high health care costs in their first year following diagnosis, according to research presented at the ASH 2017 Annual Meeting & Exposition.
Elderly patients with acute myeloid leukemia (AML) faced high health care costs in their first year following diagnosis, according to research presented at the ASH 2017 Annual Meeting & Exposition.
Elderly patients with acute...
01/29/2018
First Report Managed Care
Conference Insider
Using Neupogen, Granix, or Zarxio Reduced Chemotherapy Costs Compared to Neulasta
01/29/2018
According to a poster presentation at the ASH 2017 Annual Meeting & Exposition, Neupogen, Granix, and Zarxio were substantially less expensive for preventing neutropenia than Neulesta for an average chemotherapy treatment cycle among patients...
According to a poster presentation at the ASH 2017 Annual Meeting & Exposition, Neupogen, Granix, and Zarxio were substantially less expensive for preventing neutropenia than Neulesta for an average chemotherapy treatment cycle among patients...
According to a poster...
01/29/2018
First Report Managed Care
Conference Insider
Guideline Recommended Testing For Early Myeloma Improves Outcomes, Reduces Costs
01/29/2018
Researchers at the ASH 2017 Annual Meeting and Exposition found that performing National Comprehensive Cancer Network (NCCN) guideline recommended to detect early signs of myeloma reduces hospital costs.
Researchers at the ASH 2017 Annual Meeting and Exposition found that performing National Comprehensive Cancer Network (NCCN) guideline recommended to detect early signs of myeloma reduces hospital costs.
Researchers at the ASH 2017...
01/29/2018
First Report Managed Care
Conference Insider
Pharmacist, Provider Team Efficient & Cost-Effective for Outpatient Cancer Therapy
01/29/2018
A study presents at the ASH 2017 Annual Meeting and Exposition highlighted the benefits of a pharmacist-physician professional team in delivering outpatient cancer care.
A study presents at the ASH 2017 Annual Meeting and Exposition highlighted the benefits of a pharmacist-physician professional team in delivering outpatient cancer care.
A study presents at the ASH 2017...
01/29/2018
First Report Managed Care
Conference Insider
Xarelto Reduces Clinical Event Costs Compared to Aspirin
01/29/2018
A study at the ASH 2017 Annual Meeting & Exposition measured the cost-effectiveness of Xarelto compared to the cost-effectiveness of aspirin only. 
A study at the ASH 2017 Annual Meeting & Exposition measured the cost-effectiveness of Xarelto compared to the cost-effectiveness of aspirin only. 
A study at the ASH 2017 Annual...
01/29/2018
First Report Managed Care
Conference Insider
Cost of Stem Cell Transplant for Multiple Myeloma Decreasing
01/29/2018
Research presented at the ASH 2017 Annual Meeting & Exposition highlighted how costs for autologous stem cell transplantation have decreased over the past decade.
Research presented at the ASH 2017 Annual Meeting & Exposition highlighted how costs for autologous stem cell transplantation have decreased over the past decade.
Research presented at the ASH...
01/29/2018
First Report Managed Care
Conference Insider
Biosimilars Can Free Up Costs For Expensive Cancer Treatments
01/29/2018
Research at the ASH 2017 Annual Meeting & Exposition found that switching lymphoma patients to a biosimilar could free up budget money in order to cover the cost of expensive cancer therapies.
Research at the ASH 2017 Annual Meeting & Exposition found that switching lymphoma patients to a biosimilar could free up budget money in order to cover the cost of expensive cancer therapies.
Research at the ASH 2017 Annual...
01/29/2018
First Report Managed Care
Conference Insider
Health Systems May Not Be Following COPD 2017 Guidelines
01/29/2018
A poster presentation at the ASHP 2017 Midyear Clinical Meeting and Exposition found that health systems are not completely following the 2017 Global Initiative for Chronic Lung Disease (GOLD) guidelines for chronic obstructive pulmonary...
A poster presentation at the ASHP 2017 Midyear Clinical Meeting and Exposition found that health systems are not completely following the 2017 Global Initiative for Chronic Lung Disease (GOLD) guidelines for chronic obstructive pulmonary...
A poster presentation at the...
01/29/2018
First Report Managed Care
Conference Insider
Guidelines Aid in Management of Heart Failure, Associated Complications
01/29/2018
Guideline-based management approaches can improve quality of care and outcomes for patients with heart failure and arrhythmic complications, according to a presentation given at the ASHP 2017 Midyear Clinical Meeting and Exposition.
Guideline-based management approaches can improve quality of care and outcomes for patients with heart failure and arrhythmic complications, according to a presentation given at the ASHP 2017 Midyear Clinical Meeting and Exposition.
Guideline-based management...
01/29/2018
First Report Managed Care
Conference Insider
Pharmacy-Based Disease Management Program Reduced COPD Symptoms
01/29/2018
A poster presented at the ASHP 2017 Midyear Clinical Meeting and Exposition found that a pharmaceutical care based disease management program improved outcomes for chronic obstructive pulmonary disease (COPD) patients.
A poster presented at the ASHP 2017 Midyear Clinical Meeting and Exposition found that a pharmaceutical care based disease management program improved outcomes for chronic obstructive pulmonary disease (COPD) patients.
A poster presented at the ASHP...
01/29/2018
First Report Managed Care
Conference Insider
Evidence-Based Practices Improve Value-Based Care Across Hospitals
01/29/2018
The implementation of evidence-based treatment strategies has improved cost-savings and supported value-based care models across three distinct oncology practices within Cedars-Sinai Medical Center, according to data presented at the ASHP...
The implementation of evidence-based treatment strategies has improved cost-savings and supported value-based care models across three distinct oncology practices within Cedars-Sinai Medical Center, according to data presented at the ASHP...
The implementation of...
01/29/2018
First Report Managed Care
Conference Insider
Cancer Therapy Dose-Rounding Lowers Costs
01/29/2018
Research presented at the ASHP 2017 Midyear Clinical Meeting and Exposition found that the dose-rounding of certain monoclonal antibodies plus or minus 10% produced significant cost- and waste-savings.
Research presented at the ASHP 2017 Midyear Clinical Meeting and Exposition found that the dose-rounding of certain monoclonal antibodies plus or minus 10% produced significant cost- and waste-savings.
Research presented at the ASHP...
01/29/2018
First Report Managed Care
News Connection
Senate Passes VA Telehealth Expansion Bill
01/29/2018
The Senate recently passed the Veterans E-Health & Telemedicine Support (VETS) Act to expand access to telehealth services for VA patients.
The Senate recently passed the Veterans E-Health & Telemedicine Support (VETS) Act to expand access to telehealth services for VA patients.
The Senate recently passed the...
01/29/2018
First Report Managed Care
News Connection
Health Insurance Profits Expected to Remain Stable in 2018
01/29/2018
A recent report from AM Best, an insurance credit rating industry, predicted that health insurance profits should remain stable in 2018 despite disruptions to the ACA marketplace and other policy changes.
A recent report from AM Best, an insurance credit rating industry, predicted that health insurance profits should remain stable in 2018 despite disruptions to the ACA marketplace and other policy changes.
A recent report from AM Best, an...
01/29/2018
First Report Managed Care
News Connection
CHIP Will Not Be Reauthorized Until At Least March
01/29/2018
In a recent press release, Senators Lamar Alexander (R-Tennessee) and Susan Collins (R-Maine)—members of the Senate HELP Committee—revealed that Congress will not take legislative action on reauthorization of the Children’s Health Insurance...
In a recent press release, Senators Lamar Alexander (R-Tennessee) and Susan Collins (R-Maine)—members of the Senate HELP Committee—revealed that Congress will not take legislative action on reauthorization of the Children’s Health Insurance...
In a recent press release,...
01/29/2018
First Report Managed Care
Department
Treatment Updates for Atopic Dermatitis
01/26/2018
Eileen Koutnik-Fotopoulos
Patients with atopic dermatitis often experience a poorer health-related quality of life and social, academic, and occupational impacts, as well as a higher financial burden.
Patients with atopic dermatitis often experience a poorer health-related quality of life and social, academic, and occupational impacts, as well as a higher financial burden.
Patients with atopic dermatitis...
01/26/2018
First Report Managed Care
News
Game Changer: How CVS & Aetna Could Transform Health Care
01/19/2018
Paul Nicolaus
CVS & Aetna will combine retail pharmacy touchpoints with the power of a payer to reduce drug costs through a more fine-tuned pharmacy experience. However, this partnership could have an impact that changes more than just pharmacy. 
CVS & Aetna will combine retail pharmacy touchpoints with the power of a payer to reduce drug costs through a more fine-tuned pharmacy experience. However, this partnership could have an impact that changes more than just pharmacy. 
CVS & Aetna will combine retail...
01/19/2018
First Report Managed Care
News
Payer Roundtable: Going In-House Are Stand-Alone PBMs in Peril?
01/12/2018
Dean Celia
Following Anthem’s recent decision to start an in-house PBM, we asked a group of experts about what organizations will need to do to survive and thrive as the landscape shifts rapidly.
Following Anthem’s recent decision to start an in-house PBM, we asked a group of experts about what organizations will need to do to survive and thrive as the landscape shifts rapidly.
Following Anthem’s recent...
01/12/2018
First Report Managed Care
Managed Care Q&A
How Software Tools Can Cut Pharmacy Spending
01/12/2018
David Costill
We spoke with Michael Rea, PharmD, Founder and CEO of RX Savings Solutions, about how the burden of pharmacy spending can be reduced through use of software platforms.
We spoke with Michael Rea, PharmD, Founder and CEO of RX Savings Solutions, about how the burden of pharmacy spending can be reduced through use of software platforms.
We spoke with Michael Rea,...
01/12/2018
First Report Managed Care
News
Policy Change: The Impact of 340B Cuts on Hospitals
01/11/2018
Mary Beth Nierengarten
A recent policy change significantly cut the amount hospitals are reimbursed for drugs paid for by Medicare.
A recent policy change significantly cut the amount hospitals are reimbursed for drugs paid for by Medicare.
A recent policy change...
01/11/2018
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

January 2018 Volume 15 Issue 1

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