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Volume 17, Issue 4, April 2020 - First Report Managed Care

Featured Article

How the Payer Landscape is Shifting as the COVID-19 Pandemic Unfolds
04/14/2020
Dean Celia
We asked our experts to review and analyze payer support initiatives, cost considerations and their likely impact on claims, employer-related issues, and more in regards to the COVID-19 outbreak.
We asked our experts to review and analyze payer support initiatives, cost considerations and their likely impact on claims, employer-related issues, and more in regards to the COVID-19 outbreak.
We asked our experts to review...
04/14/2020
First Report Managed Care
Accelerating Demand and Usage of Telehealth: COVID-19
05/05/2020
Mary Beth Nierengarten
As COVID-19 continues to roll tsunami-style across the globe, strains on health care delivery systems are mandating innovative approaches to taking care of the needs of infected patients while maintaining ongoing care for patients with other...
As COVID-19 continues to roll tsunami-style across the globe, strains on health care delivery systems are mandating innovative approaches to taking care of the needs of infected patients while maintaining ongoing care for patients with other...
As COVID-19 continues to roll...
05/05/2020
First Report Managed Care
Managed Care Experts Weigh In
05/05/2020
Edan Stanley
Significant change is still to come in the fight against COVID-19. First Report Managed Care received commentary from its editorial advisory board and sourced feedback from readers on the effects COVID-19 will have on managed markets. The...
Significant change is still to come in the fight against COVID-19. First Report Managed Care received commentary from its editorial advisory board and sourced feedback from readers on the effects COVID-19 will have on managed markets. The...
Significant change is still to...
05/05/2020
First Report Managed Care
Conference Insider
Nasal Spray Epinephrine Shown to Be Bioequivalent, Effective
05/05/2020
Epinephrine administered via a nasal spray could be an effective alternative to injectors in treating anaphylaxis, according to research intended to be presented at the American Academy of Allergy, Asthma, & Immunology Annual Meeting. Three...
Epinephrine administered via a nasal spray could be an effective alternative to injectors in treating anaphylaxis, according to research intended to be presented at the American Academy of Allergy, Asthma, & Immunology Annual Meeting. Three...
Epinephrine administered via a...
05/05/2020
First Report Managed Care
Conference Insider
Oral Immunotherapy for Multiple Food Allergies Proves Safe and Effective
05/05/2020
Grouping multiple food allergies into one oral immunotherapy (OIT) course is just as safe and effective as single food OIT, according to research presented at he AAAAI Annual Meeting.
Grouping multiple food allergies into one oral immunotherapy (OIT) course is just as safe and effective as single food OIT, according to research presented at he AAAAI Annual Meeting.
Grouping multiple food allergies...
05/05/2020
First Report Managed Care
Conference Insider
Oral Immunotherapy for Multiple Food Allergies Proves Safe and Effective
05/05/2020
Grouping multiple food allergies into one oral immunotherapy (OIT) course is just as safe and effective as single food OIT, according to research presented at he AAAAI Annual Meeting.
Grouping multiple food allergies into one oral immunotherapy (OIT) course is just as safe and effective as single food OIT, according to research presented at he AAAAI Annual Meeting.
Grouping multiple food allergies...
05/05/2020
First Report Managed Care
Conference Insider
Alirocumab, Evinacumab Reduce LDL-C Levels in Adults with HoFH
05/05/2020
PCSK9 inhibitors alirocumab and novel evinacumab significantly reduced LDL-C levels in adults with homozygous familial hypercholesterolemia (HoFH), according to science presented at ACC.20/WCC virtual meeting.
PCSK9 inhibitors alirocumab and novel evinacumab significantly reduced LDL-C levels in adults with homozygous familial hypercholesterolemia (HoFH), according to science presented at ACC.20/WCC virtual meeting.
PCSK9 inhibitors alirocumab and...
05/05/2020
First Report Managed Care
Conference Insider
What Is the Risk-Benefit Tradeoff of Acute Aspirin Use for Patients With AFib?
05/05/2020
The tradeoff between increased risk of bleeding and reduced risk of ischemic events may be equal among certain patients with atrial fibrillation (AF) who take aspirin for up to 30 days, according to research presented during the 2020 American...
The tradeoff between increased risk of bleeding and reduced risk of ischemic events may be equal among certain patients with atrial fibrillation (AF) who take aspirin for up to 30 days, according to research presented during the 2020 American...
The tradeoff between increased...
05/05/2020
First Report Managed Care
Conference Insider
Counseling, E-Cigarettes Improve Smoking Cessation
05/05/2020
According to late-breaking clinical trial science presented digitally at ACC.20/WCC, patients who received smoking cessation counseling and also used electronic cigarettes with nicotine were more likely to be successful at quitting smoking,...
According to late-breaking clinical trial science presented digitally at ACC.20/WCC, patients who received smoking cessation counseling and also used electronic cigarettes with nicotine were more likely to be successful at quitting smoking,...
According to late-breaking...
05/05/2020
First Report Managed Care
Pharmacy Insight
How the Medicaid Transformation Project Helps Address the Opioid Epidemic
05/05/2020
David Smith, project executive for the Medicaid Transformation Project at Avia, discusses how the opioid epidemic has evolved and how the Medicaid Transformation Project helps transform health care and the related social needs for vulnerable...
David Smith, project executive for the Medicaid Transformation Project at Avia, discusses how the opioid epidemic has evolved and how the Medicaid Transformation Project helps transform health care and the related social needs for vulnerable...
David Smith, project executive...
05/05/2020
First Report Managed Care
Integrated Healthcare Executive
Breaking Down Pricing Transparency Rules Within Health Care Systems
05/05/2020
Julie Gould
In a recent podcast for Integrated Healthcare Executive, David Shelton, CEO of PatientMatters, discussed the rules regarding pricing transparency across health care systems and offered insight into how they will affect hospitals and patients....
In a recent podcast for Integrated Healthcare Executive, David Shelton, CEO of PatientMatters, discussed the rules regarding pricing transparency across health care systems and offered insight into how they will affect hospitals and patients....
In a recent podcast for...
05/05/2020
First Report Managed Care
Veterans Health Today
Agent Orange Exposure Increases Risk of Progression to Multiple Myeloma
05/05/2020
Patients with monoclonal gammopathy had a higher likelihood of progressing to multiple myeloma if they had past exposure to Agent Orange, a mixture of herbicides used during the Vietnam War. Researchers published the finding, based on data...
Patients with monoclonal gammopathy had a higher likelihood of progressing to multiple myeloma if they had past exposure to Agent Orange, a mixture of herbicides used during the Vietnam War. Researchers published the finding, based on data...
Patients with monoclonal...
05/05/2020
First Report Managed Care
Veterans Health Today
Differences in Unintended Pregnancies, Contraceptive Use Among Women Veterans
05/05/2020
In a population of US military veterans, women who were Hispanic or non-Hispanic black were significantly more likely to report a history of unintended pregnancy and significantly less likely to have used prescription contraception in their...
In a population of US military veterans, women who were Hispanic or non-Hispanic black were significantly more likely to report a history of unintended pregnancy and significantly less likely to have used prescription contraception in their...
In a population of US military...
05/05/2020
First Report Managed Care
Veterans Health Today
Phone-Based Work Counseling Improves Occupational, Clinical Outcomes in Veterans With Depression
05/05/2020
Adding phone-based counseling on work issues to standard depression care offered by the Veterans Health Administration (VHA) improved both work productivity and depression severity in US veterans with depression and work limitations,...
Adding phone-based counseling on work issues to standard depression care offered by the Veterans Health Administration (VHA) improved both work productivity and depression severity in US veterans with depression and work limitations,...
Adding phone-based counseling on...
05/05/2020
First Report Managed Care
Veterans Health Today
Civilians Receiving Care in the VA During COVID-19 Outbreak
05/05/2020
Julie Gould
Former VA Secretary David Shulkin, MD, shares his thoughts on the Department of Veteran Affairs providing care for nonmilitary and civilans in the wake of the novel coronavirus.
Former VA Secretary David Shulkin, MD, shares his thoughts on the Department of Veteran Affairs providing care for nonmilitary and civilans in the wake of the novel coronavirus.
Former VA Secretary David...
05/05/2020
First Report Managed Care
Veterans Health Today
As COVID-19 Pandemic Widens, Benefits of GI Bill to Continue
05/05/2020
According to the Department of Veteran Affairs (VA), as of March 21, 2020, President Trump signed into law S 3503. This law allows the agency to continue providing educational benefits to students having to take courses online due to the...
According to the Department of Veteran Affairs (VA), as of March 21, 2020, President Trump signed into law S 3503. This law allows the agency to continue providing educational benefits to students having to take courses online due to the...
According to the Department of...
05/05/2020
First Report Managed Care
News Connection
Medicare Reduces Insurance Disparities Between Immigrant and Nonimmigrant Adults
05/05/2020
The immigrant population in the United States continues to increase and public insurance programs, like Medicare, play a significant role in reducing coverage disparities for immigrants vs nonimmigrants, according to a recent JAMA Network...
The immigrant population in the United States continues to increase and public insurance programs, like Medicare, play a significant role in reducing coverage disparities for immigrants vs nonimmigrants, according to a recent JAMA Network...
The immigrant population in the...
05/05/2020
First Report Managed Care
News Connection
UnitedHealthcare Expands Resources, Waives Testing Costs for COVID-19
05/05/2020
UnitedHealthcare announced  several updates to provide people and families improved access to care and resources throughout the  outbreak.
UnitedHealthcare announced  several updates to provide people and families improved access to care and resources throughout the  outbreak.
UnitedHealthcare announced ...
05/05/2020
First Report Managed Care
News Connection
Trump, CMS Expand Medicare Telehealth Services During COVID-19
05/05/2020
The Trump administration, in collaboration with the Centers for Medicare & Medicaid Services (CMS), announced that Medicare telehealth coverage will be expanded due to the novel coronavirus (COVID-19), offering more resources and health care...
The Trump administration, in collaboration with the Centers for Medicare & Medicaid Services (CMS), announced that Medicare telehealth coverage will be expanded due to the novel coronavirus (COVID-19), offering more resources and health care...
The Trump administration, in...
05/05/2020
First Report Managed Care
News Connection
CMS Report Shows Increased Health Care Spending Over Next Decade
05/05/2020
National health expenditures are expected to rise to nearly 20% of the gross domestic product by 2028, according to new estimates released by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS).
National health expenditures are expected to rise to nearly 20% of the gross domestic product by 2028, according to new estimates released by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS).
National health expenditures are...
05/05/2020
First Report Managed Care
News Connection
UnitedHealth Group Study Supports Self-Administered COVID-19 Testing
05/05/2020
UnitedHealth Group and OptumCare clinicians conducted a study which found that patient-collected COVID-19 testing can be just as effective as a clinician-administered test, which has the potential to limit health care workers’ exposure.
UnitedHealth Group and OptumCare clinicians conducted a study which found that patient-collected COVID-19 testing can be just as effective as a clinician-administered test, which has the potential to limit health care workers’ exposure.
UnitedHealth Group and OptumCare...
05/05/2020
First Report Managed Care
News Connection
Diabetes, Chronic Conditions Linked With Higher Health Spending
05/05/2020
Chronic conditions, such as high blood pressure, heart disease, stroke, emphysema, high cholesterol, cancer, diabetes, arthritis, and asthma, are linked with food insecurity and higher health care spending, according to results of a recent...
Chronic conditions, such as high blood pressure, heart disease, stroke, emphysema, high cholesterol, cancer, diabetes, arthritis, and asthma, are linked with food insecurity and higher health care spending, according to results of a recent...
Chronic conditions, such as high...
05/05/2020
First Report Managed Care
News Connection
CMS Announces Part D Insulin Cost-Sharing Payment Model
05/05/2020
The Centers for Medicare & Medicaid Services (CMS) launched a new voluntary Part D Senior Savings model that will offer plan beneficiaries 30-day supplies of insulin with a maximum $35 copay.
The Centers for Medicare & Medicaid Services (CMS) launched a new voluntary Part D Senior Savings model that will offer plan beneficiaries 30-day supplies of insulin with a maximum $35 copay.
The Centers for Medicare &...
05/05/2020
First Report Managed Care
News Connection
New CMS, CDC Recommendations Released for Nursing Homes
05/05/2020
As the spread of the 2019 novel coronavirus (COVID-19) continues to run rampant, the Centers for Medicare & Medicaid Services (CMS) along with the Centers for Disease Control and Prevention (CDC) have released new recommendations for nursing...
As the spread of the 2019 novel coronavirus (COVID-19) continues to run rampant, the Centers for Medicare & Medicaid Services (CMS) along with the Centers for Disease Control and Prevention (CDC) have released new recommendations for nursing...
As the spread of the 2019 novel...
05/05/2020
First Report Managed Care
Managing Mental Health of Health Care Providers During a Pandemic
05/01/2020
Paul Nicolaus
The COVID-19 pandemic is taking its toll on the mental health of physicians and other frontline health care providers, prompting facilities to find ways to better manage staff wellbeing.
The COVID-19 pandemic is taking its toll on the mental health of physicians and other frontline health care providers, prompting facilities to find ways to better manage staff wellbeing.
The COVID-19 pandemic is taking...
05/01/2020
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
Balancing Medicare Advantage Denials for Patients With Diabetic Macular Edema
03/04/2024

Emry Lloyd

Emry Lloyd
Every year, millions of necessary medical service claims are denied by health care providers; policymakers want to balance these denials for those who need care and how this affects patients with diabetic macular edema.
Every year, millions of necessary medical service claims are denied by health care providers; policymakers want to balance these denials for those who need care and how this affects patients with diabetic macular edema.
Every year, millions of...
03/04/2024
First Report Managed Care
News
Study Finds Less Bacterial Diversity in Lashes of Patients With Demodex Blepharitis
04/11/2024
Jolynn Tumolo
Bacterial diversity is decreased in the eyelashes of patients with Demodex blepharitis compared with healthy volunteers, according to a study published online in Parasites & Vectors.
Bacterial diversity is decreased in the eyelashes of patients with Demodex blepharitis compared with healthy volunteers, according to a study published online in Parasites & Vectors.
Bacterial diversity is decreased...
04/11/2024
First Report Managed Care
Conference Coverage
Evolving Payer Strategies for Rare and Specialty Disease Management: Insights from Asembia 2024
05/20/2024
Matt Dickinson, PharmD, MBA, Alnylam Pharmaceuticals, led a panel to highlight payer strategies for managing rare and specialty disease products and how they continue to evolve based on Alnylam Pharmaceuticals’ 2023 Rare and Specialty Trend...
Matt Dickinson, PharmD, MBA, Alnylam Pharmaceuticals, led a panel to highlight payer strategies for managing rare and specialty disease products and how they continue to evolve based on Alnylam Pharmaceuticals’ 2023 Rare and Specialty Trend...
Matt Dickinson, PharmD, MBA,...
05/20/2024
First Report Managed Care
News
Comparing Rural and Urban HIV Risk Behaviors Among Adolescent Sexual Minority Males
06/11/2024
Hannah Musick
Research highlights differing HIV risk behaviors and service use between urban and rural adolescent sexual minority males in the US, emphasizing the need for targeted interventions to reduce infection rates in rural areas where access to...
Research highlights differing HIV risk behaviors and service use between urban and rural adolescent sexual minority males in the US, emphasizing the need for targeted interventions to reduce infection rates in rural areas where access to...
Research highlights differing...
06/11/2024
First Report Managed Care
Behind the Bill
CMS Updates Guidance on M3P: What to Expect from Medicare’s 2025 Rollout
07/24/2024
Katie Hayes, MJ
The M3P offers financial relief by spreading payment throughout the year, and CMS’ latest guidance clarifies key outreach parameters.
The M3P offers financial relief by spreading payment throughout the year, and CMS’ latest guidance clarifies key outreach parameters.
The M3P offers financial relief...
07/24/2024
First Report Managed Care

April 2020 Volume 17 Issue 4

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