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October 2015 - FRMC

Hillary Clinton`s Plan to Address Drug Costs: Experts Weigh In
11/11/2015
Dean Celia
The Democratic presidential candidate has released a briefing that she believes tackles the issue head-on. Our managed care authorities analyze key aspects of the Clinton proposal, and reveal which parts have merit—and where things fall...
The Democratic presidential candidate has released a briefing that she believes tackles the issue head-on. Our managed care authorities analyze key aspects of the Clinton proposal, and reveal which parts have merit—and where things fall...
The Democratic presidential...
11/11/2015
First Report Managed Care
Conference Insider
New Treatment Strategies Could Address Unmet Needs in Dyslipidemia Patients
11/11/2015
Jill Sederstorm
New treatment strategies are being introduced for dyslipidemia patients with the greatest need, creating new treatment opportunities to overcome the limitations of conventional hyper-cholesterolemia therapies, according to a recent...
New treatment strategies are being introduced for dyslipidemia patients with the greatest need, creating new treatment opportunities to overcome the limitations of conventional hyper-cholesterolemia therapies, according to a recent...
New treatment strategies are...
11/11/2015
First Report Managed Care
Conference Insider
Achieving Value-Based Care Through Interviewing
11/11/2015
Jill Sederstorm
Motivational interviewing can increase patient engagement, promote adherence, and produce better outcomes, which, in turn, could ultimately lead to significant health care cost savings, according to a recent presentation at the CRS Fall.
Motivational interviewing can increase patient engagement, promote adherence, and produce better outcomes, which, in turn, could ultimately lead to significant health care cost savings, according to a recent presentation at the CRS Fall.
Motivational interviewing can...
11/11/2015
First Report Managed Care
News Connection
Diagnoses for Chronic Illnesses Expected to Increase Under the ACA
11/11/2015
Melissa D. Cooper
A recent study published in Health Affairs found that chronic illness diagnoses are more likely to occur among insured individuals, suggesting that with more individuals covered under the Affordable Care Act (ACA), the number of chronic...
A recent study published in Health Affairs found that chronic illness diagnoses are more likely to occur among insured individuals, suggesting that with more individuals covered under the Affordable Care Act (ACA), the number of chronic...
A recent study published...
11/11/2015
First Report Managed Care
Consolidation’s Impact on Quality Analyzed
11/11/2015
Dean Celia
As mid-sized organizations gobble up the small, and the big become gigantic, here is what our experts believe it means for metrics-driven health delivery. They also weigh in on the fate of regional players.
As mid-sized organizations gobble up the small, and the big become gigantic, here is what our experts believe it means for metrics-driven health delivery. They also weigh in on the fate of regional players.
As mid-sized organizations...
11/11/2015
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

Commentary
Next-Generation Utilization Management: Managing Utilization and Cost Without Denial of Service​​​
03/01/2024
Amit Gupta, MD
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is...
03/01/2024
First Report Managed Care
Shannon Smith Headshot
Commentary
Adapting to Change: Navigating the New CMS Prior Authorization Guidelines in Health Care
04/02/2024

Shannon Smith, RN, BSN

Shannon Smith, RN, BSN
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry...
04/02/2024
First Report Managed Care
Conference Coverage
Rare Orphan, Oncology, and Specialty Drugs in Development: Review of Therapeutic Areas, Designations, and Launch Projections
05/01/2024
Danielle Sposato
The specialty pharmacy pipeline was the subject of one of many informative sessions at the annual Asembia Summit this year. Key insights were shared about current drugs in the pipeline according to their drug designations, the phase of each...
The specialty pharmacy pipeline was the subject of one of many informative sessions at the annual Asembia Summit this year. Key insights were shared about current drugs in the pipeline according to their drug designations, the phase of each...
The specialty pharmacy pipeline...
05/01/2024
First Report Managed Care
News
Using Mindfulness-Based Intervention to Improve Fatigue, Mood Challenges in Adolescents With Neuroimmune Disease
05/28/2024
Grace Taylor, MS, MA
Study examines the effectiveness of the Learning to BREATHE mindfulness-based intervention in improving fatigue and mood challenges in a adolescent population with neuroimmune disease.
Study examines the effectiveness of the Learning to BREATHE mindfulness-based intervention in improving fatigue and mood challenges in a adolescent population with neuroimmune disease.
Study examines the effectiveness...
05/28/2024
First Report Managed Care
Leyla Henderson
Conference Coverage
Strategies for Enhancing Infusion Patient Experiences
07/10/2024
Leyla Henderson
An NICA 2024 session speaker shares innovative strategies for enhancing patient satisfaction and improving outcomes in health care settings, emphasizing the importance of patient-centered care and individualized experiences.
An NICA 2024 session speaker shares innovative strategies for enhancing patient satisfaction and improving outcomes in health care settings, emphasizing the importance of patient-centered care and individualized experiences.
An NICA 2024 session speaker...
07/10/2024
First Report Managed Care

October 2015 Volume 12 Issue 10

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