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Volume 16, Issue 5, May 2019 - First Report Managed Care

Featured Article

05/17/2019
Dean Celia
The Senate Finance Committee recently examined the complicated role pharmacy benefit managers play in the pricing of pharmaceuticals. Six prominent themes emerged. First Report Managed Care consulted with a panel of experts to assess the...
The Senate Finance Committee recently examined the complicated role pharmacy benefit managers play in the pricing of pharmaceuticals. Six prominent themes emerged. First Report Managed Care consulted with a panel of experts to assess the...
The Senate Finance Committee...
05/17/2019
First Report Managed Care
05/17/2019
Paul Nicolaus
A bold new initiative, along with proposed funding, seeks to eliminate the spread of HIV in the United States over the next decade. We gathered insight into this public health initiative’s implications for managed care stakeholders.
A bold new initiative, along with proposed funding, seeks to eliminate the spread of HIV in the United States over the next decade. We gathered insight into this public health initiative’s implications for managed care stakeholders.
A bold new initiative, along...
05/17/2019
First Report Managed Care
05/17/2019
Mary Beth Nierengarten
As the opioid crisis turned national epidemic continues to plague our country, controversy rises on how to continue to treat patients for chronic pain without putting those same patients at risk of abusing medication or developing addictions.
As the opioid crisis turned national epidemic continues to plague our country, controversy rises on how to continue to treat patients for chronic pain without putting those same patients at risk of abusing medication or developing addictions.
As the opioid crisis turned...
05/17/2019
First Report Managed Care
Interview
05/17/2019
Julie Gould
In order to better understand why inadequate risk adjustment could counterproductively reduce payments to groups, First Report Managed Care spoke with Christina A Nguyen, AB, and co-author Mary Beth Landrum, PhD, both from Harvard Medical...
In order to better understand why inadequate risk adjustment could counterproductively reduce payments to groups, First Report Managed Care spoke with Christina A Nguyen, AB, and co-author Mary Beth Landrum, PhD, both from Harvard Medical...
In order to better understand...
05/17/2019
First Report Managed Care
Formulary Frontlines®
05/17/2019
Russell J. Spjut, PharmD
Russel Spjut, PharmD, discusses various treatment options for diabetes, as well as explores the most recent technologies aimed at improving management of the disease.
Russel Spjut, PharmD, discusses various treatment options for diabetes, as well as explores the most recent technologies aimed at improving management of the disease.
Russel Spjut, PharmD, discusses...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
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...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
According to a recent study published online in JAMA Network Open, the use of a collaborative chronic care model (CCM) in general clinical practice settings for individuals with complex mental health conditions can improve overall health...
According to a recent study published online in JAMA Network Open, the use of a collaborative chronic care model (CCM) in general clinical practice settings for individuals with complex mental health conditions can improve overall health...
According to a recent study...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
Among veterans willing and able to be treated, the Department of Veteran Affairs (VA) announced it is on track to eliminate the hepatitis C virus (HCV) in as few as 2 months. 
Among veterans willing and able to be treated, the Department of Veteran Affairs (VA) announced it is on track to eliminate the hepatitis C virus (HCV) in as few as 2 months. 
Among veterans willing and able...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
As another continued effort to improve health care services for veterans, the Department of Veteran Affairs (VA) has announced that two doctors from a Baltimore VA Medical Center recently demonstrated how 3D printing at the VA is more useful...
As another continued effort to improve health care services for veterans, the Department of Veteran Affairs (VA) has announced that two doctors from a Baltimore VA Medical Center recently demonstrated how 3D printing at the VA is more useful...
As another continued effort to...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
To further enhance their point-of-sale discount program introduced last year, UnitedHealthcare and OptumRx are expanding their program for all new employee-sponsored plans, in an effort to make medications more affordable and improve outcomes.
To further enhance their point-of-sale discount program introduced last year, UnitedHealthcare and OptumRx are expanding their program for all new employee-sponsored plans, in an effort to make medications more affordable and improve outcomes.
To further enhance their...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
Federal Judge, John Bates, submitted a 43-page ruling that blocks the Trump administration’s efforts to further oversee association health plans (AHPs). The Final Rule from the administration would allow employers to form associations to...
Federal Judge, John Bates, submitted a 43-page ruling that blocks the Trump administration’s efforts to further oversee association health plans (AHPs). The Final Rule from the administration would allow employers to form associations to...
Federal Judge, John Bates,...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
According to a report from the Pew Charitable Trusts, it is estimated that US retail pharmaceutical drug spending increased 26.8% between 2012 and 2016, an increase of over $90 billion.
According to a report from the Pew Charitable Trusts, it is estimated that US retail pharmaceutical drug spending increased 26.8% between 2012 and 2016, an increase of over $90 billion.
According to a report from the...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
The Medicare Board of Trustees released the annual report measuring the stability and success of the program, as well as the current state of the Hospital Insurance Trust Fund and the Supplementary Medical Insurance (SMI) Trust Fund, the two...
The Medicare Board of Trustees released the annual report measuring the stability and success of the program, as well as the current state of the Hospital Insurance Trust Fund and the Supplementary Medical Insurance (SMI) Trust Fund, the two...
The Medicare Board of Trustees...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
According to a research published in JAMA Internal Medicine, Medicare reimbursement rules that went into effect in January are shifting the financial burden of readmission rate penalties to hospitals that serve wealthier populations.
According to a research published in JAMA Internal Medicine, Medicare reimbursement rules that went into effect in January are shifting the financial burden of readmission rate penalties to hospitals that serve wealthier populations.
According to a research...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
Research published by JAMA showed that while workplace wellness programs may improve employees’ health behaviors, there is little to no significant effects on clinical measures of health, health care spending and utilization, absenteeism,...
Research published by JAMA showed that while workplace wellness programs may improve employees’ health behaviors, there is little to no significant effects on clinical measures of health, health care spending and utilization, absenteeism,...
Research published by JAMA...
05/17/2019
First Report Managed Care
News Connection
05/17/2019
Researchers found that hardwiring a hospital’s electronic health record (EHR) system to provide data on the appropriate times to order Gastrointestinal Pathogen Panel (GIPP) nearly halved the amount of inappropriate testing.
Researchers found that hardwiring a hospital’s electronic health record (EHR) system to provide data on the appropriate times to order Gastrointestinal Pathogen Panel (GIPP) nearly halved the amount of inappropriate testing.
Researchers found that...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
James Kenney, RPH, MBA, new president of AMCP addressed attendees of the AMCP Managed Care & Specialty Pharmacy summit, where he discussed the importance of focusing on patient outcomes and innovating technology.
James Kenney, RPH, MBA, new president of AMCP addressed attendees of the AMCP Managed Care & Specialty Pharmacy summit, where he discussed the importance of focusing on patient outcomes and innovating technology.
James Kenney, RPH, MBA, new...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
In a session at the AMCP Managed Care & Specialty Pharmacy Annual Meeting 2019, Nicole Brandt, PharmD, MBA, BCGP, BCPP, FASCP, executive director, The Peter Lamy Center on Drug Therapy and Aging Professor, Pharmacy Practice and Science...
In a session at the AMCP Managed Care & Specialty Pharmacy Annual Meeting 2019, Nicole Brandt, PharmD, MBA, BCGP, BCPP, FASCP, executive director, The Peter Lamy Center on Drug Therapy and Aging Professor, Pharmacy Practice and Science...
In a session at the AMCP Managed...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
To better understand payer insights in health care trends and also identify the most promising solutions to foster wider implementation of innovative strategies, a 33-item web-based survey was distributed to US pharmacy, contracting, and...
To better understand payer insights in health care trends and also identify the most promising solutions to foster wider implementation of innovative strategies, a 33-item web-based survey was distributed to US pharmacy, contracting, and...
To better understand payer...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
In an effort to address escalating drug expenditures, formulary exclusions have arisen, and according to a recent study, the exclusion formulary has resulted in significant pharmacy savings but was not associated with increased medical cost...
In an effort to address escalating drug expenditures, formulary exclusions have arisen, and according to a recent study, the exclusion formulary has resulted in significant pharmacy savings but was not associated with increased medical cost...
In an effort to address...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
Researchers recently found that patient-reported outcomes (PROs) were no different among patients treated with calcitonin gene-related peptide (CGRP) antagonists or onabotulinumtoxinA (ONA) for the indication of chronic migraine prophylaxis. 
Researchers recently found that patient-reported outcomes (PROs) were no different among patients treated with calcitonin gene-related peptide (CGRP) antagonists or onabotulinumtoxinA (ONA) for the indication of chronic migraine prophylaxis. 
Researchers recently found that...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
Researchers recently found that patient-reported outcomes (PROs) were no different among patients treated with calcitonin gene-related peptide (CGRP) antagonists or onabotulinumtoxinA (ONA) for the indication of chronic migraine prophylaxis. 
Researchers recently found that patient-reported outcomes (PROs) were no different among patients treated with calcitonin gene-related peptide (CGRP) antagonists or onabotulinumtoxinA (ONA) for the indication of chronic migraine prophylaxis. 
Researchers recently found that...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
Melissa Andel, MPP, vice president of health policy at Applied Policy and First Report Managed Care advisory board member, provided insight on progress made in relation to the Trump administration’s May 2018 blueprint to lower drug prices and...
Melissa Andel, MPP, vice president of health policy at Applied Policy and First Report Managed Care advisory board member, provided insight on progress made in relation to the Trump administration’s May 2018 blueprint to lower drug prices and...
Melissa Andel, MPP, vice...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
When patients received abuse-deterrent formulation (ADF) opioids, lower rates of opioid abuse, health care utilization, and medical costs were reported, according to recent analysis findings. The findings were presented at the AMCP Managed...
When patients received abuse-deterrent formulation (ADF) opioids, lower rates of opioid abuse, health care utilization, and medical costs were reported, according to recent analysis findings. The findings were presented at the AMCP Managed...
When patients received...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
A newly developed program, known as the Chronic Pain Program, was created as a multidisciplinary care management and coaching program that provides support and resources to patients with chronic pain. According to a team of researchers that...
A newly developed program, known as the Chronic Pain Program, was created as a multidisciplinary care management and coaching program that provides support and resources to patients with chronic pain. According to a team of researchers that...
A newly developed program, known...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
Within the health care decision-making process, the impact of patient-reported outcomes (PRO) and clinical outcome assessments (COAs) on payers is often low, despite efforts to include the patient voice, according to recent survey results...
Within the health care decision-making process, the impact of patient-reported outcomes (PRO) and clinical outcome assessments (COAs) on payers is often low, despite efforts to include the patient voice, according to recent survey results...
Within the health care...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
Within an integrated health care system, a pharmacist-managed deprescribing program, which focused on select antidiabetics among older patients with well-controlled type 2 diabetes, resulted in sustained benefit after one year in reducing the...
Within an integrated health care system, a pharmacist-managed deprescribing program, which focused on select antidiabetics among older patients with well-controlled type 2 diabetes, resulted in sustained benefit after one year in reducing the...
Within an integrated health care...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
Human papillomavirus (HPV) vaccination rates in Alabama counties correlate with the highest incident rates of HPV-related cancer, according to data presented at the Society for Gynecologic Oncology’s 50th Annual Meeting. 
Human papillomavirus (HPV) vaccination rates in Alabama counties correlate with the highest incident rates of HPV-related cancer, according to data presented at the Society for Gynecologic Oncology’s 50th Annual Meeting. 
Human papillomavirus (HPV)...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
Results from a randomized phase 2 trial presented at the Society for Gynecologic Oncology’s 50th Annual Meeting show that a newly developed immunotherapy treatment combined with standard chemotherapy improve the prognosis for patients with...
Results from a randomized phase 2 trial presented at the Society for Gynecologic Oncology’s 50th Annual Meeting show that a newly developed immunotherapy treatment combined with standard chemotherapy improve the prognosis for patients with...
Results from a randomized phase...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
Results from a randomized phase 2 trial presented at the Society for Gynecologic Oncology’s 50th Annual Meeting show that a newly developed immunotherapy treatment combined with standard chemotherapy improve the prognosis for patients with...
Results from a randomized phase 2 trial presented at the Society for Gynecologic Oncology’s 50th Annual Meeting show that a newly developed immunotherapy treatment combined with standard chemotherapy improve the prognosis for patients with...
Results from a randomized phase...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
According to research presented at the Society for Gynecologic Oncology’s 50th Annual Meeting, patients with recurrent ovarian cancer experienced more time without symptoms or toxicities when taking niraparib as a maintenance therapy. 
According to research presented at the Society for Gynecologic Oncology’s 50th Annual Meeting, patients with recurrent ovarian cancer experienced more time without symptoms or toxicities when taking niraparib as a maintenance therapy. 
According to research presented...
05/17/2019
First Report Managed Care
Conference Insider
05/17/2019
According to research presented at the Society for Gynecologic Oncology’s 50th Annual Meeting, patients with recurrent ovarian cancer experienced more time without symptoms or toxicities when taking niraparib as a maintenance therapy. 
According to research presented at the Society for Gynecologic Oncology’s 50th Annual Meeting, patients with recurrent ovarian cancer experienced more time without symptoms or toxicities when taking niraparib as a maintenance therapy. 
According to research presented...
05/17/2019
First Report Managed Care