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HMP Global

May 2013 - FRMC

Conference Insider
Three Ways to Improve Medication Nonadherence
05/17/2013
Jill Sederstorm
San Diego—Medication nonadherence is a costly problem in healthcare, but predictive modeling, value-based insurance design (VBID), and the application of gamification could help improve adherence rates. These 3 strategies and the challenges...
San Diego—Medication nonadherence is a costly problem in healthcare, but predictive modeling, value-based insurance design (VBID), and the application of gamification could help improve adherence rates. These 3 strategies and the challenges...
San Diego—Medication...
05/17/2013
First Report Managed Care
Department
Oral Medication Aubagio® Approved for Multiple Sclerosis
05/17/2013
Tim Casey
San Diego—In the past, patients with multiple sclerosis were required to administer medications intravenously or via injections, a painful process for some, but they had no other choices. Now, though, treatment options have expanded into oral...
San Diego—In the past, patients with multiple sclerosis were required to administer medications intravenously or via injections, a painful process for some, but they had no other choices. Now, though, treatment options have expanded into oral...
San Diego—In the past, patients...
05/17/2013
First Report Managed Care
Conference Insider
Auvi-Q™ for Type 1 Allergic Reactions and Anaphylaxis
05/17/2013
Tim Casey
San Diego—As many as 6 million people in the United States are at risk of anaphylaxis, and the prevalence is increasing, especially among people <20 years of age, according to several studies. In August 2012, the FDA approved Auvi-Q™...
San Diego—As many as 6 million people in the United States are at risk of anaphylaxis, and the prevalence is increasing, especially among people <20 years of age, according to several studies. In August 2012, the FDA approved Auvi-Q™...
San Diego—As many as 6 million...
05/17/2013
First Report Managed Care
Conference Insider
Rare Diseases and Orphan Drugs: Status, Reimbursement, and Management
05/17/2013
Tori Socha
San Diego—There are approximately 7000 diseases that are categorized as rare, but only 5% of those have approved treatments. The 1984 amendment to the Orphan Drug Act of 1983 (ODA) defined a rare disease as one that affects 200,000 people in...
San Diego—There are approximately 7000 diseases that are categorized as rare, but only 5% of those have approved treatments. The 1984 amendment to the Orphan Drug Act of 1983 (ODA) defined a rare disease as one that affects 200,000 people in...
San Diego—There are...
05/17/2013
First Report Managed Care
Guideline-Preferred ART Regimens for Patients with HIV
05/17/2013
Tori Socha
San Diego—In March 2012, the U.S. Department of Health & Human Services (HHS) issued guidelines for the use of antiretroviral therapy (ART) in patients with HIV that recommend 4 specific preferred ART regimens for ART-naïve patients.
San Diego—In March 2012, the U.S. Department of Health & Human Services (HHS) issued guidelines for the use of antiretroviral therapy (ART) in patients with HIV that recommend 4 specific preferred ART regimens for ART-naïve patients.
San Diego—In March 2012, the...
05/17/2013
First Report Managed Care
Conference Insider
Results of the EMD Serono Specialty Digest™, 9th Edition
05/17/2013
Tim Casey
San Diego—With major provisions from the Patient Protection and Affordable Care Act becoming effective next year, the healthcare industry is facing a challenge keeping medication costs in check due to, in part, the proliferation of expensive...
San Diego—With major provisions from the Patient Protection and Affordable Care Act becoming effective next year, the healthcare industry is facing a challenge keeping medication costs in check due to, in part, the proliferation of expensive...
San Diego—With major provisions...
05/17/2013
First Report Managed Care
Conference Insider
Rapidly Evolving Specialty Pharmacy Industry
05/17/2013
Mary Beth Nierengarten
San Diego—With the dominance of specialty drugs driving increasing prescription medication expenditures, pharmacists need to prepare for significant growth in specialty pharmaceuticals and its impact on medication benefit plans.
San Diego—With the dominance of specialty drugs driving increasing prescription medication expenditures, pharmacists need to prepare for significant growth in specialty pharmaceuticals and its impact on medication benefit plans.
San Diego—With the dominance of...
05/17/2013
First Report Managed Care
Conference Insider
Identifying the Economic Burden of Pain
05/17/2013
Tori Socha
San Diego—Pain is challenging to treat and the healthcare cost burden of pain is substantial. According to researchers, understanding the dynamics of the economic burden of pain will help providers and payers allocate resources more...
San Diego—Pain is challenging to treat and the healthcare cost burden of pain is substantial. According to researchers, understanding the dynamics of the economic burden of pain will help providers and payers allocate resources more...
San Diego—Pain is challenging to...
05/17/2013
First Report Managed Care
Expenditures in Patients Taking Noninsulin Antidiabetic Agents
05/17/2013
Tori Socha
San Diego—Healthcare decision makers face challenges in optimizing disease management in patients with type 2 diabetes mellitus (T2DM). Increasing healthcare expenditures can be attributed, in part, to the costs, including medical and...
San Diego—Healthcare decision makers face challenges in optimizing disease management in patients with type 2 diabetes mellitus (T2DM). Increasing healthcare expenditures can be attributed, in part, to the costs, including medical and...
San Diego—Healthcare decision...
05/17/2013
First Report Managed Care
Conference Insider
DMD Early Adherence as Predictor of Future Adherence
05/17/2013
Tori Socha
San Diego—Multiple sclerosis generally presents in young adults, resulting in a greater loss of productivity and quality of life compared with other diseases. Frequency of relapses can be reduced with use of disease-modifying drugs (DMDs),...
San Diego—Multiple sclerosis generally presents in young adults, resulting in a greater loss of productivity and quality of life compared with other diseases. Frequency of relapses can be reduced with use of disease-modifying drugs (DMDs),...
San Diego—Multiple sclerosis...
05/17/2013
First Report Managed Care
Conference Insider
Adherence to Desvenlafaxine Improved with Refill and Save Program
05/17/2013
Tori Socha
San Diego—The annual prevalence of major depressive disorder (MDD) in the United States is 7% and the lifetime prevalence rate is 16%. Patients with MDD experience depressed mood, fatigue, lack of interest in activities, insomnia or...
San Diego—The annual prevalence of major depressive disorder (MDD) in the United States is 7% and the lifetime prevalence rate is 16%. Patients with MDD experience depressed mood, fatigue, lack of interest in activities, insomnia or...
San Diego—The annual prevalence...
05/17/2013
First Report Managed Care
Conference Insider
Bevacizumab Infusion in Office/Clinic versus Outpatient Hospital Setting
05/17/2013
Tori Socha
San Diego—According to researchers, declining health plan reimbursements for physician-administered chemotherapy may shift the population of oncology patients treated with infused chemotherapy from office/clinic settings to outpatient...
San Diego—According to researchers, declining health plan reimbursements for physician-administered chemotherapy may shift the population of oncology patients treated with infused chemotherapy from office/clinic settings to outpatient...
San Diego—According to...
05/17/2013
First Report Managed Care
Conference Insider
Adapting Decision Analytic Models to Provide New Perspective
05/17/2013
Mary Mihalovic
San Diego—Existing healthcare decision models may not always address real-world needs of decision makers, according to information presented during a Contemporary Issues session at the AMCP meeting titled Adapting Decision Analytic Models to...
San Diego—Existing healthcare decision models may not always address real-world needs of decision makers, according to information presented during a Contemporary Issues session at the AMCP meeting titled Adapting Decision Analytic Models to...
San Diego—Existing healthcare...
05/17/2013
First Report Managed Care
Conference Insider
SafeUseNow: A Prescriber Intervention Program
05/17/2013
Tori Socha
According to statistics from the CDC, nonmedical use of prescription drugs is the second leading cause of accidental death in the US.
According to statistics from the CDC, nonmedical use of prescription drugs is the second leading cause of accidental death in the US.
According to statistics from the...
05/17/2013
First Report Managed Care
Adherence to and Utilization of Antimuscarinic Agents for OAB
05/17/2013
Tori Socha
San Diego—Compared with other chronic conditions, national trends indicate that adherence to medications to treat overactive bladder (OAB) is relatively poor. Antimuscarinic medications, including oxybutynin, are commonly prescribed for OAB....
San Diego—Compared with other chronic conditions, national trends indicate that adherence to medications to treat overactive bladder (OAB) is relatively poor. Antimuscarinic medications, including oxybutynin, are commonly prescribed for OAB....
San Diego—Compared with other...
05/17/2013
First Report Managed Care
Saxagliptin Less Costly in Specific Patient Populations
05/17/2013
Eileen Koutnik-Fotopoulos
San Diego—Diabetes patients treated with saxagliptin were significantly less prone to inpatient hospitalizations or emergency department (ED) visits than patients treated with sulfonylureas. Total healthcare costs were also lower for the...
San Diego—Diabetes patients treated with saxagliptin were significantly less prone to inpatient hospitalizations or emergency department (ED) visits than patients treated with sulfonylureas. Total healthcare costs were also lower for the...
San Diego—Diabetes patients...
05/17/2013
First Report Managed Care
Conference Insider
Federal and State Legislative Update
05/17/2013
Kevin L. Carter
San Diego—The federal budget sequester struggle, the continuing movement toward the implementation of the Patient Protection and Affordable Care Act (ACA), and issues facing Medicare Part D are among the most significant legislative and...
San Diego—The federal budget sequester struggle, the continuing movement toward the implementation of the Patient Protection and Affordable Care Act (ACA), and issues facing Medicare Part D are among the most significant legislative and...
San Diego—The federal budget...
05/17/2013
First Report Managed Care
Healthcare Resource Utilization after Initiation of a Triptan
05/17/2013
Jill Sederstorm
San Diego—A new retrospective analysis of patients suffering from migraines found that the use of triptans did not decrease the utilization of healthcare resources, and, in some cases, was associated with an increase in utilization. These...
San Diego—A new retrospective analysis of patients suffering from migraines found that the use of triptans did not decrease the utilization of healthcare resources, and, in some cases, was associated with an increase in utilization. These...
San Diego—A new retrospective...
05/17/2013
First Report Managed Care
Pharmacy Benefits in Health Exchanges
05/17/2013
Eileen Koutnik-Fotopoulos
San Diego—Currently, health plans are designing pharmacy benefits to be used in conjunction with the medical benefits for the state health exchanges. Successful health plans will engage pharmacists to improve the design and management of the...
San Diego—Currently, health plans are designing pharmacy benefits to be used in conjunction with the medical benefits for the state health exchanges. Successful health plans will engage pharmacists to improve the design and management of the...
San Diego—Currently, health...
05/17/2013
First Report Managed Care
Conference Insider
ACOs—A Model for Healthcare Reform
05/17/2013
Tori Socha
San Diego—Accountable care organizations (ACOs), included as part of the Patient Protection and Affordable Care Act, are groups of physicians, hospitals, and other healthcare providers who form an organization to provide coordinated quality...
San Diego—Accountable care organizations (ACOs), included as part of the Patient Protection and Affordable Care Act, are groups of physicians, hospitals, and other healthcare providers who form an organization to provide coordinated quality...
San Diego—Accountable care...
05/17/2013
First Report Managed Care
Managed Care Organizations and Medicare Star Ratings
05/17/2013
Tori Socha
San Diego—The emerging model for healthcare in the United States is value-driven healthcare, according to speakers at a Contemporary Issues session at the AMCP meeting. The session was titled How Much of the $3 Billion in Star Rating Bonuses...
San Diego—The emerging model for healthcare in the United States is value-driven healthcare, according to speakers at a Contemporary Issues session at the AMCP meeting. The session was titled How Much of the $3 Billion in Star Rating Bonuses...
San Diego—The emerging model for...
05/17/2013
First Report Managed Care
Health Outcomes Associated with Insulin after OAD Therapies
05/17/2013
Kevin L. Carter
San Diego—Despite clinical practice that usually does not include the introduction of insulin therapy in patients newly diagnosed with type 2 diabetes mellitus (T2DM), most patients will eventually require treatment with insulin to maintain...
San Diego—Despite clinical practice that usually does not include the introduction of insulin therapy in patients newly diagnosed with type 2 diabetes mellitus (T2DM), most patients will eventually require treatment with insulin to maintain...
San Diego—Despite clinical...
05/17/2013
First Report Managed Care
Health Insurance Marketplace Launches Come with Challenges
05/17/2013
Mary Mihalovic
San Diego—The challenges that come with the launch of the new health insurance marketplaces as 2014 rapidly approaches were topic for discussion in a Contemporary Issues session at the AMCP meeting titled Fostering Healthy Markets:...
San Diego—The challenges that come with the launch of the new health insurance marketplaces as 2014 rapidly approaches were topic for discussion in a Contemporary Issues session at the AMCP meeting titled Fostering Healthy Markets:...
San Diego—The challenges that...
05/17/2013
First Report Managed Care
Units and Costs of Comparable Insulin Supplied to Patients
05/17/2013
Kevin L. Carter
San Diego—Many companies that supply insulin can offer products with similar pharmacokinetic or pharmacodynamic (PK/PD) properties. This is the case with the active ingredients of insulin products produced by Eli Lilly and Company (LLY) and...
San Diego—Many companies that supply insulin can offer products with similar pharmacokinetic or pharmacodynamic (PK/PD) properties. This is the case with the active ingredients of insulin products produced by Eli Lilly and Company (LLY) and...
San Diego—Many companies that...
05/17/2013
First Report Managed Care
The Medical Moment of Truth Can Reduce Gaps in Care
05/17/2013
Kevin L. Carter
San Diego—The best time for a physician and patient to decide on an effective, comprehensive, and manageable treatment plan is during the initial prescribing visit. This is, according to a Contemporary Issues session at the AMCP meeting, the...
San Diego—The best time for a physician and patient to decide on an effective, comprehensive, and manageable treatment plan is during the initial prescribing visit. This is, according to a Contemporary Issues session at the AMCP meeting, the...
San Diego—The best time for a...
05/17/2013
First Report Managed Care
Costs for Medicare Patients Significantly Higher during Leucovorin Shortage
05/17/2013
Jill Sederstorm
San Diego—The cost of care has significantly increased for Medicare patients taking leucovorin and/or Fusilev® (levoleucovorin) since the first leucovorin shortage in 2008, according to findings from a recent retrospective analysis presented...
San Diego—The cost of care has significantly increased for Medicare patients taking leucovorin and/or Fusilev® (levoleucovorin) since the first leucovorin shortage in 2008, according to findings from a recent retrospective analysis presented...
San Diego—The cost of care has...
05/17/2013
First Report Managed Care
Conference Insider
Medicaid MCOs Face Challenges as Population Grows
05/17/2013
Jill Sederstorm
San Diego—The Medicaid patient population is expected to grow under the Patient Protection and Affordable Care Act (ACA), leaving managed care organizations (MCOs) to face increasing challenges as they attempt to limit costs, particularly in...
San Diego—The Medicaid patient population is expected to grow under the Patient Protection and Affordable Care Act (ACA), leaving managed care organizations (MCOs) to face increasing challenges as they attempt to limit costs, particularly in...
San Diego—The Medicaid patient...
05/17/2013
First Report Managed Care
Utilization Patterns of Infliximab for RA
05/17/2013
Eileen Koutnik-Fotopoulos
San Diego—An understanding of the current usage patterns of infliximab in the treatment of rheumatoid arthritis (RA) is a crucial component in the management of patients. Because real-world data of weight-based utilization patterns of this...
San Diego—An understanding of the current usage patterns of infliximab in the treatment of rheumatoid arthritis (RA) is a crucial component in the management of patients. Because real-world data of weight-based utilization patterns of this...
San Diego—An understanding of...
05/17/2013
First Report Managed Care
A Member-Directed Medication Adherence Intervention
05/17/2013
Tori Socha
San Diego—Engaging patients and improving medication adherence was the aim of a program implemented in a population of dual-eligible special needs Medicare Advantage (MA) beneficiaries. The program involved the cooperation of a MA plan...
San Diego—Engaging patients and improving medication adherence was the aim of a program implemented in a population of dual-eligible special needs Medicare Advantage (MA) beneficiaries. The program involved the cooperation of a MA plan...
San Diego—Engaging patients and...
05/17/2013
First Report Managed Care
Self-injected SC versus IV Biologic Agents for RA
05/17/2013
Mary Beth Nierengarten
Based on a new claims-based algorithm developed to evaluate the effectiveness of biologics for rheumatoid arthritis (RA), self-injected subcutaneous (SC) first-line biologic agents are more effective than intravenous (IV) administered agents...
Based on a new claims-based algorithm developed to evaluate the effectiveness of biologics for rheumatoid arthritis (RA), self-injected subcutaneous (SC) first-line biologic agents are more effective than intravenous (IV) administered agents...
Based on a new claims-based...
05/17/2013
First Report Managed Care
Personalized Medicine: Changing the Paradigm for Value
05/17/2013
Mary Beth Nierengarten
Personalized medicine is promising to revolutionize medical care by tailoring diagnostic and therapeutic approaches to individual patients based on an improved understanding of genetics and molecular biology.
Personalized medicine is promising to revolutionize medical care by tailoring diagnostic and therapeutic approaches to individual patients based on an improved understanding of genetics and molecular biology.
Personalized medicine is...
05/17/2013
First Report Managed Care
Interventions Needed to Improve Adherence to Antiretroviral Therapy
05/17/2013
Mary Beth Nierengarten
More than a quarter of patients with HIV treated with antiretroviral therapy (ART) do not adhere to therapy, according to a study presented during a poster session at the AMCP meeting.
More than a quarter of patients with HIV treated with antiretroviral therapy (ART) do not adhere to therapy, according to a study presented during a poster session at the AMCP meeting.
More than a quarter of patients...
05/17/2013
First Report Managed Care
Improving Part D Star Ratings through Collaboration
05/17/2013
Eileen Koutnik-Fotopoulos
The Centers for Medicare & Medicaid Services (CMS) Star Ratings program has heightened plan sponsors’ attention for the need to improve medication adherence and other aspects of medication use.
The Centers for Medicare & Medicaid Services (CMS) Star Ratings program has heightened plan sponsors’ attention for the need to improve medication adherence and other aspects of medication use.
The Centers for Medicare &...
05/17/2013
First Report Managed Care
Switching from Oral to Intrauterine Contraception May Result in Cost Savings for Health Plans
05/17/2013
Mary Mihalovic
Switching oral contraceptive (OC) users to a low-dose levonorgestrel-intrauterine (LNG-IUS) system may result in overall cost savings for healthcare plans, due to subsequent decreases in pharmacy costs and a decrease in medical costs related...
Switching oral contraceptive (OC) users to a low-dose levonorgestrel-intrauterine (LNG-IUS) system may result in overall cost savings for healthcare plans, due to subsequent decreases in pharmacy costs and a decrease in medical costs related...
Switching oral contraceptive...
05/17/2013
First Report Managed Care
News
Managed Care Strategies for Multiple Sclerosis
05/17/2013
Tim Casey
In the United States, approximately 400,000 people have multiple sclerosis (MS). Each day, there are approximately 200 new diagnoses of the disease, presenting a burden on patients who typically live with MS for 20 to 40 years as well as the...
In the United States, approximately 400,000 people have multiple sclerosis (MS). Each day, there are approximately 200 new diagnoses of the disease, presenting a burden on patients who typically live with MS for 20 to 40 years as well as the...
In the United States,...
05/17/2013
First Report Managed Care
Payers’ Views on Specialty Pharmaceuticals Market
05/17/2013
Tim Casey
Between 2007 and 2011, specialty drug costs grew from 15% to 20% each year, whereas spending on traditional drugs increased <5% each year, according to the Express Scripts 2011 drug trend report.
Between 2007 and 2011, specialty drug costs grew from 15% to 20% each year, whereas spending on traditional drugs increased <5% each year, according to the Express Scripts 2011 drug trend report.
Between 2007 and 2011, specialty...
05/17/2013
First Report Managed Care
Site of Care May Impact Breast Cancer Management and Economic Outcomes
05/17/2013
Mary Mihalovic
Patients with nonmetastatic HER2+ breast cancer who were administered trastuzumab in an outpatient hospital setting incurred higher total monthly healthcare costs compared with patients treated in an office clinic, according to information...
Patients with nonmetastatic HER2+ breast cancer who were administered trastuzumab in an outpatient hospital setting incurred higher total monthly healthcare costs compared with patients treated in an office clinic, according to information...
Patients with nonmetastatic...
05/17/2013
First Report Managed Care
Utilizing CER to Manage Rheumatoid Arthritis
05/17/2013
Tim Casey
San Diego—For managed care professionals, rheumatoid arthritis (RA) is among the most expensive and difficult diseases to manage. The FDA has approved several drugs to treat the disease, but it is sometimes hard to determine the option that...
San Diego—For managed care professionals, rheumatoid arthritis (RA) is among the most expensive and difficult diseases to manage. The FDA has approved several drugs to treat the disease, but it is sometimes hard to determine the option that...
San Diego—For managed care...
05/17/2013
First Report Managed Care
Integrated Pharmacy Program
05/17/2013
Tori Socha
The Medicaid system includes patients described as complex, who comprise a challenging and transient group of patients. 
The Medicaid system includes patients described as complex, who comprise a challenging and transient group of patients. 
The Medicaid system includes...
05/17/2013
First Report Managed Care
News
Multiple Sclerosis Treatment Options
05/17/2013
Tim Casey
As the FDA approves more drugs to treat multiple sclerosis, healthcare professionals are attempting to understand the costs, benefits, and risks associated with the various treatment options.
As the FDA approves more drugs to treat multiple sclerosis, healthcare professionals are attempting to understand the costs, benefits, and risks associated with the various treatment options.
As the FDA approves more drugs...
05/17/2013
First Report Managed Care
Healthcare Issues and Trends
05/17/2013
Tim Casey
San Diego—For the first time in 60 years, prescription drug sales declined in the United States in 2012, falling by 1%. At the same time, the number of prescriptions filled increased only 1.2% last year, according to data from IMS Health, a...
San Diego—For the first time in 60 years, prescription drug sales declined in the United States in 2012, falling by 1%. At the same time, the number of prescriptions filled increased only 1.2% last year, according to data from IMS Health, a...
San Diego—For the first time in...
05/17/2013
First Report Managed Care
Hepatitis C Treatment Options Likely to Expand
05/17/2013
Tim Casey
San Diego—The FDA approvals of boceprevir and telaprevir in 2011 were seen as breakthroughs in treating patients with hepatitis C. The oral drugs are protease inhibitors used in combination with pegylated interferon and ribavirin. These...
San Diego—The FDA approvals of boceprevir and telaprevir in 2011 were seen as breakthroughs in treating patients with hepatitis C. The oral drugs are protease inhibitors used in combination with pegylated interferon and ribavirin. These...
San Diego—The FDA approvals of...
05/17/2013
First Report Managed Care
AMCP Looks to the Future
05/17/2013
Tim Casey
Edith Rosato, RPh, began her position as AMCP’s chief executive officer in October 2011, coinciding with unprecedented change in the healthcare industry. Economic conditions were weak, and companies were preparing for provisions in the...
Edith Rosato, RPh, began her position as AMCP’s chief executive officer in October 2011, coinciding with unprecedented change in the healthcare industry. Economic conditions were weak, and companies were preparing for provisions in the...
Edith Rosato, RPh, began her...
05/17/2013
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
Task Force Publishes Target-To-Treat Guidance for GCA and PMR
03/12/2024
Jolynn Tumolo
An international task force recently published the first target-to-treat (T2T) recommendations for patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in the Annals of the Rheumatic Diseases.
An international task force recently published the first target-to-treat (T2T) recommendations for patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in the Annals of the Rheumatic Diseases.
An international task force...
03/12/2024
First Report Managed Care
Asembia: More Than an Annual Conference
04/15/2024

Emry Lloyd

Emry Lloyd
Asembia, established in 2005, pioneered the recognition and promotion of specialty pharmacies, focusing on becoming a leader in the specialty pharmacy group purchasing organization sector. Offering scalable solutions, including prescription...
Asembia, established in 2005, pioneered the recognition and promotion of specialty pharmacies, focusing on becoming a leader in the specialty pharmacy group purchasing organization sector. Offering scalable solutions, including prescription...
Asembia, established in 2005,...
04/15/2024
First Report Managed Care
Conference Coverage
Addressing Suicidal Ideation in Persons With Multiple Sclerosis: Developing a Predictive Nomogram
05/22/2024
Hannah Musick
New research explored the development of a predictive nomogram to identify persons with multiple sclerosis at higher risk of suicidal ideation, emphasizing the importance of behavioral risk factors in this vulnerable population.
New research explored the development of a predictive nomogram to identify persons with multiple sclerosis at higher risk of suicidal ideation, emphasizing the importance of behavioral risk factors in this vulnerable population.
New research explored the...
05/22/2024
First Report Managed Care
News
Johnson & Johnson Expands Use of Prezcobix for Pediatric Patients in the US
06/21/2024
Hannah Musick
Johnson & Johnson aims to expand use of its HIV-1 therapy, Prezcobix, for younger patients in the US, potentially paving the way for improved treatment options for pediatric patients with the virus.
Johnson & Johnson aims to expand use of its HIV-1 therapy, Prezcobix, for younger patients in the US, potentially paving the way for improved treatment options for pediatric patients with the virus.
Johnson & Johnson aims to expand...
06/21/2024
First Report Managed Care
Brian Esterly Headshot
Interview
Insights on the 2024 Medicare Physician Fee Schedule: Implications and Opportunities for Virtual Care Management Services
07/26/2024
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician...
07/26/2024
First Report Managed Care

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