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June 2018 - First Report Managed Care

Featured Article

Inside President Trump’s Drug Pricing Policy
07/05/2018
Dean Celia
Our experts dig in to the Trump Administration’s blueprint to lower drug prices in order to identify which strategies may be implemented soon and discuss how payers and employers should prepare. 
Our experts dig in to the Trump Administration’s blueprint to lower drug prices in order to identify which strategies may be implemented soon and discuss how payers and employers should prepare. 
Our experts dig in to the Trump...
07/05/2018
First Report Managed Care
Formulary Frontlines®
Understanding Novel Therapies for Acute Migraine
07/05/2018
Richard G. Wenzel, PharmD
Richard G Wenzel, PharmD, pharmacologist at the Diamond Headache Inpatient Unit, discusses novel therapies for acute migraines that will soon be FDA-approved and will provide an opportunity to reassess migraine approaches for this...
Richard G Wenzel, PharmD, pharmacologist at the Diamond Headache Inpatient Unit, discusses novel therapies for acute migraines that will soon be FDA-approved and will provide an opportunity to reassess migraine approaches for this...
Richard G Wenzel, PharmD,...
07/05/2018
First Report Managed Care
Conference Insider
Cannabis Cost-Effective for Treatment of Painful Neuropathy
07/05/2018
A poster presented at the AAPM 2018 Annual Meeting found that smoked cannabis is a cost-effective treatment for pain related to diabetic neuropathy when added to second- and third-line treatments.
A poster presented at the AAPM 2018 Annual Meeting found that smoked cannabis is a cost-effective treatment for pain related to diabetic neuropathy when added to second- and third-line treatments.
A poster presented at the AAPM...
07/05/2018
First Report Managed Care
Managed Care Q&A
PBMs Need to Evolve as Specialty Pharmacy Grows
07/05/2018
David Costill
An interview with Albert Thigpen, president and chief operating officer of CastiaRx.
An interview with Albert Thigpen, president and chief operating officer of CastiaRx.
An interview with Albert...
07/05/2018
First Report Managed Care
Viewpoint
Know Your Members: Identifying and Addressing Social Determinants of Health in Low-Income Populations
07/05/2018
Jennifer Forster, MPA
According to a report from the Kaiser Family Foundation, social determinants of health are “the structural determinants and conditions in which people are born, grow, live, work, and age.”
According to a report from the Kaiser Family Foundation, social determinants of health are “the structural determinants and conditions in which people are born, grow, live, work, and age.”
According to a report from the...
07/05/2018
First Report Managed Care
Experimenting With Nonmedical Benefits to Improve Outcomes
07/05/2018
Mary Beth Nierengarten
What the US health care system does not primarily focus on, is how to maintain and improve the health of individuals through services that are not directly linked to a medical need.
What the US health care system does not primarily focus on, is how to maintain and improve the health of individuals through services that are not directly linked to a medical need.
What the US health care system...
07/05/2018
First Report Managed Care
Acquisitions: Payers Gobble Up Provider Networks
07/05/2018
Paul Nicolaus
While the media is focused on the impact of threats to the health care industry from outside forces like Amazon and Walmart, Payers have been quietly buying up huge provider groups from across the country, indicating that the biggest changes...
While the media is focused on the impact of threats to the health care industry from outside forces like Amazon and Walmart, Payers have been quietly buying up huge provider groups from across the country, indicating that the biggest changes...
While the media is focused on...
07/05/2018
First Report Managed Care
Conference Insider
Understanding COPD Diagnosis and Management
07/05/2018
During the NAMCP 2018 Spring Managed Care Forum, Sanjay Sethi, MD, division chief of Pulmonary, Critical Care, and Sleep Medicine at the University of Buffalo, outlined the recent clinical advances in the diagnosis and treatment of COPD.
During the NAMCP 2018 Spring Managed Care Forum, Sanjay Sethi, MD, division chief of Pulmonary, Critical Care, and Sleep Medicine at the University of Buffalo, outlined the recent clinical advances in the diagnosis and treatment of COPD.
During the NAMCP 2018 Spring...
07/05/2018
First Report Managed Care
Conference Insider
Improving MS Outcomes Through Individualized Care
07/05/2018
A presentation at the NAMCP 2018 Spring Managed Care Forum outlined how individualized care can improve multiple sclerosis (MS) outcomes and highlighted how value-based strategies can mitigate costs among these patients.
A presentation at the NAMCP 2018 Spring Managed Care Forum outlined how individualized care can improve multiple sclerosis (MS) outcomes and highlighted how value-based strategies can mitigate costs among these patients.
A presentation at the NAMCP 2018...
07/05/2018
First Report Managed Care
Conference Insider
Improving Decision Making in Individualized HIV Treatment
07/05/2018
Mary Watson Montgomery, MD, of the Brigham and Women’s Hospital at Harvard Medical School, discussed emerging HIV therapies and how health care decision makers can help patients access high quality HIV care at the NAMCP Spring Managed Care...
Mary Watson Montgomery, MD, of the Brigham and Women’s Hospital at Harvard Medical School, discussed emerging HIV therapies and how health care decision makers can help patients access high quality HIV care at the NAMCP Spring Managed Care...
Mary Watson Montgomery, MD, of...
07/05/2018
First Report Managed Care
Conference Insider
Increasing Access and Decreasing Costs With Biosimilars
07/05/2018
During the NAMCP Spring Managed Care Forum 2018, Robert M Rifkin, MD, FACP, medical director of biosimilars at McKesson Specialty Health, The US Oncology Network, explained how biosimilars can add value by increasing access and decreasing...
During the NAMCP Spring Managed Care Forum 2018, Robert M Rifkin, MD, FACP, medical director of biosimilars at McKesson Specialty Health, The US Oncology Network, explained how biosimilars can add value by increasing access and decreasing...
During the NAMCP Spring Managed...
07/05/2018
First Report Managed Care
Conference Insider
How Policy Changes in Washington Could Disrupt Health Care
07/05/2018
During Asembia’s 2018 Specialty Pharmacy Summit, Bruce Japsen, Health Care Contributing Writer at Forbes conducted a Q&A with Matt Brow, executive vice president and general manager at Avalere, digging into how forthcoming policy changes in...
During Asembia’s 2018 Specialty Pharmacy Summit, Bruce Japsen, Health Care Contributing Writer at Forbes conducted a Q&A with Matt Brow, executive vice president and general manager at Avalere, digging into how forthcoming policy changes in...
During Asembia’s 2018 Specialty...
07/05/2018
First Report Managed Care
Conference Insider
Value Continues to be the Hot Topic at Asembia Oncology Panel Discussion
07/05/2018
A panel discussion, titled “The Future of Oncology and Impact on the Pharmaceuticals Supply Chain,” at Asembia’s 2018 Specialty Pharmacy Summit focused heavily on value in the oncology drug space and who gets to determine what the definition...
A panel discussion, titled “The Future of Oncology and Impact on the Pharmaceuticals Supply Chain,” at Asembia’s 2018 Specialty Pharmacy Summit focused heavily on value in the oncology drug space and who gets to determine what the definition...
A panel discussion, titled “The...
07/05/2018
First Report Managed Care
Conference Insider
Better Alignment With Consumer Drivers Needed in Health Care, Specialty Pharmacy
07/05/2018
Albert Thigpen, president and CEO of the newly formed CastiaRx, discussed how health care and specialty pharmacy services are failing to keep up with the rapidly changing drivers of consumers and explained some areas that need to be addressed...
Albert Thigpen, president and CEO of the newly formed CastiaRx, discussed how health care and specialty pharmacy services are failing to keep up with the rapidly changing drivers of consumers and explained some areas that need to be addressed...
Albert Thigpen, president and...
07/05/2018
First Report Managed Care
Conference Insider
Patients Using Opioids Before Joint Replacement More Costly
07/05/2018
A recent study presented at the AAPM 2018 Annual Meeting found that patients who use opioids before elective joint replacement surgery have higher health care costs and longer length of stay. 
A recent study presented at the AAPM 2018 Annual Meeting found that patients who use opioids before elective joint replacement surgery have higher health care costs and longer length of stay. 
A recent study presented at the...
07/05/2018
First Report Managed Care
Conference Insider
Pain Associated With Increased Frequency of ED Revisits
07/05/2018
According to a presentation at the AAPM 2018 Annual Meeting, pain is associated with an increase in emergency department (ED) revisits.
According to a presentation at the AAPM 2018 Annual Meeting, pain is associated with an increase in emergency department (ED) revisits.
According to a presentation at...
07/05/2018
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

News
Dairy, Gluten Show No Major Effect on MS Activity and Quality of Life
02/15/2024
Jolynn Tumolo
Dairy and gluten intake had no substantial effects on disease activity and quality of life in a retrospective study of 186 patients with multiple sclerosis (MS). Researchers published their findings online in Multiple Sclerosis Journal –...
Dairy and gluten intake had no substantial effects on disease activity and quality of life in a retrospective study of 186 patients with multiple sclerosis (MS). Researchers published their findings online in Multiple Sclerosis Journal –...
Dairy and gluten intake had no...
02/15/2024
First Report Managed Care
News
Health Care Administration Inefficiencies: Lessons from the 2024 Medallion Report
03/26/2024
Hannah Musick
Discover the impact of manual processes and staffing challenges on payer enrollment and credentialing workflows in the 2024 State of Payer Enrollment and Credentialing Report by Medallion.
Discover the impact of manual processes and staffing challenges on payer enrollment and credentialing workflows in the 2024 State of Payer Enrollment and Credentialing Report by Medallion.
Discover the impact of manual...
03/26/2024
First Report Managed Care
IPF letters
Formulary Frontlines®
New Therapies in Development for Idiopathic Pulmonary Fibrosis (IPF) Address Existing Challenges With Diagnosis and Management
05/13/2024

Reviewed by Elizabeth Volkmann, MD, MS

Reviewed by Elizabeth Volkmann, MD, M...
IPF is a chronic, progressive interstitial lung disease that presents a significant burden to ~3 million patients worldwide. Despite ongoing challenges with IPF diagnosis and management, new therapies in development are showing promise.
IPF is a chronic, progressive interstitial lung disease that presents a significant burden to ~3 million patients worldwide. Despite ongoing challenges with IPF diagnosis and management, new therapies in development are showing promise.
IPF is a chronic, progressive...
05/13/2024
First Report Managed Care
Conference Coverage
Immune Colitis Associated With Rituximab Therapy in Relapsing Multiple Sclerosis
05/24/2024
Hannah Musick
A case study highlighted rare immune colitis associated with rituximab therapy in a patient with relapsing multiple sclerosis (RMS) and emphasizes the need for increased awareness and monitoring of this potential adverse effect in clinical...
A case study highlighted rare immune colitis associated with rituximab therapy in a patient with relapsing multiple sclerosis (RMS) and emphasizes the need for increased awareness and monitoring of this potential adverse effect in clinical...
A case study highlighted rare...
05/24/2024
First Report Managed Care
Katie Devlin
Interview
Strategies for Adjusting With Health Care Interoperability
07/01/2024
Katie Devlin, DHSc, MS, CPHIMS
In this interview, Katie Devlin, VP of Interoperability at Cotiviti, discusses the impact of major shifts like TEFCA and the CMS Interoperability Rule on health plans, emphasizing the importance of joining a QHIN to increase data...
In this interview, Katie Devlin, VP of Interoperability at Cotiviti, discusses the impact of major shifts like TEFCA and the CMS Interoperability Rule on health plans, emphasizing the importance of joining a QHIN to increase data...
In this interview, Katie Devlin,...
07/01/2024
First Report Managed Care

June 2018 Volume 15 Issue 6

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