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Volume 16, Issue 4, April 2019 - First Report Managed Care

Featured Article

Managed Care Innovator: Donald Rucker
04/19/2019
Dean Celia
Donald Rucker, MD, discusses progress in the areas of interoperability, reducing provider burden, and giving patients more control of their health data, as well as suggests how managed care stakeholders can position themselves for success as...
Donald Rucker, MD, discusses progress in the areas of interoperability, reducing provider burden, and giving patients more control of their health data, as well as suggests how managed care stakeholders can position themselves for success as...
Donald Rucker, MD, discusses...
04/19/2019
First Report Managed Care
Adoption of Value-Based Reimbursement Among Private Insurers
04/19/2019
Mary Beth Nierengarten
As the federal government moves toward adopting and expanding value-based payment models, private market providers and payers are striving to smoothly transition to the new models, furthering the transformation of thought and practice of how...
As the federal government moves toward adopting and expanding value-based payment models, private market providers and payers are striving to smoothly transition to the new models, furthering the transformation of thought and practice of how...
As the federal government moves...
04/19/2019
First Report Managed Care
The Growing Influence of Younger Generations
04/19/2019
Paul Nicolaus
Millennials and members of Generation Z are more dissatisfied than their older counterparts with some aspects of traditional health care. Here’s how these younger adults and their expectations are shaping the current and future managed care...
Millennials and members of Generation Z are more dissatisfied than their older counterparts with some aspects of traditional health care. Here’s how these younger adults and their expectations are shaping the current and future managed care...
Millennials and members of...
04/19/2019
First Report Managed Care
Digital Medicines: A Solution to Medication Nonadherence?
04/19/2019
Jeff Craven
Could medication with built-in digital sensors improve medication adherence and reduce health care costs? Experts discuss the potential benefits of novel digital medicines against privacy concerns of large-scale data collection.
Could medication with built-in digital sensors improve medication adherence and reduce health care costs? Experts discuss the potential benefits of novel digital medicines against privacy concerns of large-scale data collection.
Could medication with built-in...
04/19/2019
First Report Managed Care
Formulary Frontlines®
Managing Chronic Asthma
04/19/2019
Barbara Yawn, MD, MSc; Edan Stanley
Asthma is a condition of hypersensitivity to common exposures associated with chronic airway inflammation, bronchial hyperreactivity with increased mucus and airway edema, obstruction, and narrowing. Barbara Yawn, MD, MSc, FAFFP, outlines...
Asthma is a condition of hypersensitivity to common exposures associated with chronic airway inflammation, bronchial hyperreactivity with increased mucus and airway edema, obstruction, and narrowing. Barbara Yawn, MD, MSc, FAFFP, outlines...
Asthma is a condition of...
04/19/2019
First Report Managed Care
Managed Care Q&A
Exploring the Cost Benefits of Cloud-Enabled Testing for RA Diagnosis
04/19/2019
Julie Gould
Research economist, Katalin Bognar, PhD, Precision Health Economics, discusses the benefits of the use of rapid, cloud-enabled, onsite testing for rheumatoid arthritis.
Research economist, Katalin Bognar, PhD, Precision Health Economics, discusses the benefits of the use of rapid, cloud-enabled, onsite testing for rheumatoid arthritis.
Research economist, Katalin...
04/19/2019
First Report Managed Care
News Connection
Telehealth Services Outpace Other Venues of Care
04/19/2019
Between 2016 and 2017, the national utilization of telehealth as a service grew 53%, according to data from a recent white paper outlining service trends and medical pricing published by FAIR Health.
Between 2016 and 2017, the national utilization of telehealth as a service grew 53%, according to data from a recent white paper outlining service trends and medical pricing published by FAIR Health.
Between 2016 and 2017, the...
04/19/2019
First Report Managed Care
News Connection
J&J Announce Price of Newly Approved Depression Treatment
04/19/2019
Johnson & Johnson announced the US Federal Drug Administration approved the new, ketamine-like, nasal spray depression treatment, Spravato (esketamine). The pharmaceutical company confirmed that Spravato, will be priced at $590 for a 56mg...
Johnson & Johnson announced the US Federal Drug Administration approved the new, ketamine-like, nasal spray depression treatment, Spravato (esketamine). The pharmaceutical company confirmed that Spravato, will be priced at $590 for a 56mg...
Johnson & Johnson announced the...
04/19/2019
First Report Managed Care
News Connection
Coverage of Nondrug Treatments for Back Pain Inconsistent Across Insurers
04/19/2019
Although most insurers tend to cover physical and occupational therapy as well as chiropractic care for the treatment of chronic low back pain, coverage for acupuncture and psychological interventions is less consistent despite evidence...
Although most insurers tend to cover physical and occupational therapy as well as chiropractic care for the treatment of chronic low back pain, coverage for acupuncture and psychological interventions is less consistent despite evidence...
Although most insurers tend to...
04/19/2019
First Report Managed Care
News Connection
Newly Approved Nasal Spray Made Available for Veterans
04/19/2019
The Department of Veterans Affairs (VA) recently announced that its health care providers will be able to offer veterans the newly approved nasal spray for treatment-resistant depression. 
The Department of Veterans Affairs (VA) recently announced that its health care providers will be able to offer veterans the newly approved nasal spray for treatment-resistant depression. 
The Department of Veterans...
04/19/2019
First Report Managed Care
News Connection
Better Work Performance Among Engaged Employees Within VA Medical Centers
04/19/2019
A recent study revealed that engaged employees within the Department of Veteran Affairs (VA) medical centers had higher patient satisfaction, better call center performance, and lower turnover among registered nurses.
A recent study revealed that engaged employees within the Department of Veteran Affairs (VA) medical centers had higher patient satisfaction, better call center performance, and lower turnover among registered nurses.
A recent study revealed that...
04/19/2019
First Report Managed Care
Conference Insider
PBMI Highlights the 2019 Trends in Specialty Drug Benefits
04/19/2019
On the final day of PBMI’s 2019 National Conference, Jane Lutz, executive director of PBMI, Sharon Frazee, PhD, MPH, vice president of research and education of PBMI, and Rick Gates, senior vice president, pharmacy and health care, Walgreens,...
On the final day of PBMI’s 2019 National Conference, Jane Lutz, executive director of PBMI, Sharon Frazee, PhD, MPH, vice president of research and education of PBMI, and Rick Gates, senior vice president, pharmacy and health care, Walgreens,...
On the final day of PBMI’s 2019...
04/19/2019
First Report Managed Care
Conference Insider
On the Gene Therapy Pipeline
04/19/2019
In a session at PBMI’s 2019 Annual Conference, Megan Pasicznyk, PharmD, MBA, senior director, specialty market development, Express Scripts, presented on recent breakthroughs on gene therapies, and discussed the implications payers must...
In a session at PBMI’s 2019 Annual Conference, Megan Pasicznyk, PharmD, MBA, senior director, specialty market development, Express Scripts, presented on recent breakthroughs on gene therapies, and discussed the implications payers must...
In a session at PBMI’s 2019...
04/19/2019
First Report Managed Care
Conference Insider
Perspectives on the Opioid Crisis
04/19/2019
The opioid crisis is not new but continues to grow more prevalent in the news and has begun to touch every walk of life. At PBMI’s 2019 National Conference, a panel focused on prescription opioid vigilance comprised a patient, prescriber,...
The opioid crisis is not new but continues to grow more prevalent in the news and has begun to touch every walk of life. At PBMI’s 2019 National Conference, a panel focused on prescription opioid vigilance comprised a patient, prescriber,...
The opioid crisis is not new but...
04/19/2019
First Report Managed Care
Conference Insider
The Future of Health Care
04/19/2019
The health care industry is constantly evolving and reform efforts stem from what seems like every angle in the current political climate. During his keynote address at PBMI’s 2019 National Conference, Thomas Price, MD, physician and former...
The health care industry is constantly evolving and reform efforts stem from what seems like every angle in the current political climate. During his keynote address at PBMI’s 2019 National Conference, Thomas Price, MD, physician and former...
The health care industry is...
04/19/2019
First Report Managed Care
Conference Insider
Can Alcohol Improve Heart Function?
04/19/2019
Individuals with no known cardiovascular (CV) risk factors who consume a moderate amount of alcohol tend to have more favorable echocardiography results than their counterparts who do not consume alcohol, according to new research presented...
Individuals with no known cardiovascular (CV) risk factors who consume a moderate amount of alcohol tend to have more favorable echocardiography results than their counterparts who do not consume alcohol, according to new research presented...
Individuals with no known...
04/19/2019
First Report Managed Care
Conference Insider
Time-Restricted Eating May Improve BP, Weight Loss in Metabolic Syndrome
04/19/2019
Time-restricted eating (TRE) may help significantly lower blood pressure and promote weight loss in individuals with metabolic syndrome—even without a change in physical activity—according to new research.
Time-restricted eating (TRE) may help significantly lower blood pressure and promote weight loss in individuals with metabolic syndrome—even without a change in physical activity—according to new research.
Time-restricted eating (TRE) may...
04/19/2019
First Report Managed Care
Conference Insider
Oral Anticoagulants Are Underused Among Patients With AFib and Advanced CKD
04/19/2019
Individuals with atrial fibrillation (AFib) who have advanced chronic kidney disease are more likely to use aspirin than oral anticoagulants, according to new research presented at the American College of Cardiology’s Annual Scientific...
Individuals with atrial fibrillation (AFib) who have advanced chronic kidney disease are more likely to use aspirin than oral anticoagulants, according to new research presented at the American College of Cardiology’s Annual Scientific...
Individuals with atrial...
04/19/2019
First Report Managed Care
Conference Insider
Emergency Departments Could Play Larger Role in Treating Substance Abuse Patients
04/19/2019
Research presented at American Academy of Pain Medicine’s 2019 Annual Meeting shows that hospitals have an opportunity to embody a more substantial role in treating substance use disorder (SUD) patients in emergency departments (EDs),...
Research presented at American Academy of Pain Medicine’s 2019 Annual Meeting shows that hospitals have an opportunity to embody a more substantial role in treating substance use disorder (SUD) patients in emergency departments (EDs),...
Research presented at American...
04/19/2019
First Report Managed Care
Conference Insider
Ongoing Study Analyzes Outcomes of Implanted Spinal Cord Stimulation Devices
04/19/2019
Newer technology could improve chronic pain in patients utilizing spinal cord stimulation (SCS) systems according to science presented at the American Academy of Pain Medicine’s 2019 Annual Meeting.
Newer technology could improve chronic pain in patients utilizing spinal cord stimulation (SCS) systems according to science presented at the American Academy of Pain Medicine’s 2019 Annual Meeting.
Newer technology could improve...
04/19/2019
First Report Managed Care
Conference Insider
Ongoing Study Analyzes Outcomes of Implanted Spinal Cord Stimulation Devices
04/19/2019
Newer technology could improve chronic pain in patients utilizing spinal cord stimulation (SCS) systems according to science presented at the American Academy of Pain Medicine’s 2019 Annual Meeting.
Newer technology could improve chronic pain in patients utilizing spinal cord stimulation (SCS) systems according to science presented at the American Academy of Pain Medicine’s 2019 Annual Meeting.
Newer technology could improve...
04/19/2019
First Report Managed Care
Conference Insider
Clearer Guidelines Needed for Patients’ Self-Managing Opioid Prescriptions
04/19/2019
The opioid crisis is among the top concerns related to health care reform. Researchers at the American Academy of Pain Medicine’s 2019 Annual Meeting presented statistics that while concern is extremely justified, there are critical gaps in...
The opioid crisis is among the top concerns related to health care reform. Researchers at the American Academy of Pain Medicine’s 2019 Annual Meeting presented statistics that while concern is extremely justified, there are critical gaps in...
The opioid crisis is among the...
04/19/2019
First Report Managed Care
Conference Insider
Costs of AD High Among Patients With Medicaid
04/19/2019
The cost for treating atopic dermatitis (AD) varies based on whether patients have commercial insurance or Medicaid, according to a poster study presented at the 2019 American Academy of Dermatology Annual Meeting.
The cost for treating atopic dermatitis (AD) varies based on whether patients have commercial insurance or Medicaid, according to a poster study presented at the 2019 American Academy of Dermatology Annual Meeting.
The cost for treating atopic...
04/19/2019
First Report Managed Care
Conference Insider
Regular Screening Cost-Effective Following Melanoma Diagnosis
04/19/2019
Regular screening after a stage 1 melanoma diagnosis detected more melanoma at earlier stages and at a lower cost per melanoma compared with screening only once over 10 years, according to a recent poster study presented at the 2019 American...
Regular screening after a stage 1 melanoma diagnosis detected more melanoma at earlier stages and at a lower cost per melanoma compared with screening only once over 10 years, according to a recent poster study presented at the 2019 American...
Regular screening after a stage...
04/19/2019
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

Yash Prajapati
Videos
Navigating the Evolution of Digital Solutions in Health Care
02/27/2024

Featuring Yash Prajapati, consultant at ZS Associates 

Featuring Yash Prajapati, consul...
Join us in exploring the challenges and opportunities in the development, approval, and integration of digital therapeutic solutions with ZS Associates consultant Yash Prajapati.
Join us in exploring the challenges and opportunities in the development, approval, and integration of digital therapeutic solutions with ZS Associates consultant Yash Prajapati.
Join us in exploring the...
02/27/2024
First Report Managed Care
Tejaswi Kompala
Videos
Personalizing Weight Loss Management With GLP-1 Agonists
04/05/2024

Featuring Tejaswi Kompala, MD, head of cardiometabolic clinical strategy, Teladoc 

Featuring Tejaswi Kompala, MD, h...
Delve into the rising demand for anti-obesity medications, the complexities of obesity management, and the importance of personalized approaches in improving cardiometabolic health in this insightful interview.
Delve into the rising demand for anti-obesity medications, the complexities of obesity management, and the importance of personalized approaches in improving cardiometabolic health in this insightful interview.
Delve into the rising demand for...
04/05/2024
First Report Managed Care
News
Debate Emerges Over FDA's Plan to Regulate Laboratory Medical Tests
05/03/2024
Hannah Musick
The FDA's new regulations on laboratory-developed tests have sparked debate over access to innovative tests and patient care in the medical field, with opponents arguing that increased oversight could hinder the development of crucial new...
The FDA's new regulations on laboratory-developed tests have sparked debate over access to innovative tests and patient care in the medical field, with opponents arguing that increased oversight could hinder the development of crucial new...
The FDA's new regulations on...
05/03/2024
First Report Managed Care
Interview
Key Pharmaceutical Pipeline Developments: Insights from Industry Experts
05/29/2024
Learn about promising drugs currently in the pharmaceutical pipeline and the impact of FDA interventions from presenters at AMCP 2024.
Learn about promising drugs currently in the pharmaceutical pipeline and the impact of FDA interventions from presenters at AMCP 2024.
Learn about promising drugs...
05/29/2024
First Report Managed Care
News
‘Hidden’ Signs May Signal Subclinical Progression in Early MS
07/15/2024
Jolynn Tumolo
Focusing solely on relapse rates and magnetic resonance imaging (MRI) lesion activity to track disease progression in patients with early multiple sclerosis (MS) may miss indicators of subclinical disease activity, with important implications...
Focusing solely on relapse rates and magnetic resonance imaging (MRI) lesion activity to track disease progression in patients with early multiple sclerosis (MS) may miss indicators of subclinical disease activity, with important implications...
Focusing solely on relapse rates...
07/15/2024
First Report Managed Care

April 2019 Volume 16 Issue 4

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