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Volume 18, Issue 2, March/April 2021 - First Report Managed Care

First Report
Vibegron Proves Effective as Oral Therapy for Patients With Overactive Bladder
04/12/2021
Edan Stanley
While OAB is not associated with high mortality rates, its effects on quality of life and overall burden can be stressful to patients and diagnosis/treatment is often delayed due to patients’ lack of understanding of available treatments.
While OAB is not associated with high mortality rates, its effects on quality of life and overall burden can be stressful to patients and diagnosis/treatment is often delayed due to patients’ lack of understanding of available treatments.
While OAB is not associated with...
04/12/2021
First Report Managed Care
Integrated Healthcare Executive
Why Health Systems, Providers Should Inform Patients of New Alliance Aimed at Improving Health Care for Women
04/12/2021
Julie Gould
Ted Anderson, MD, PhD, American College of Obstetricians and Gynecologists (ACOG), Mary Lou Ballweg, Endometriosis Association, along with Tammy Boyd and Kineta Sealey, both from the Black Women’s Health Imperative (BWHI), discuss a new...
Ted Anderson, MD, PhD, American College of Obstetricians and Gynecologists (ACOG), Mary Lou Ballweg, Endometriosis Association, along with Tammy Boyd and Kineta Sealey, both from the Black Women’s Health Imperative (BWHI), discuss a new...
Ted Anderson, MD, PhD, American...
04/12/2021
First Report Managed Care
Cover Story
A Population-Based Approach to Curb the Mental Health Crisis
04/12/2021
Mary Beth Nierengarten
While the COVID-19 pandemic has resulted in increased morbidity and mortality rates on a global scale, it has also exacerbated and brought the mental health crisis to the forefront. More than ever, people are seeking mental health services...
While the COVID-19 pandemic has resulted in increased morbidity and mortality rates on a global scale, it has also exacerbated and brought the mental health crisis to the forefront. More than ever, people are seeking mental health services...
While the COVID-19 pandemic has...
04/12/2021
First Report Managed Care
Viewpoint
Five Trends Driving Adoption of Holistic Strategies: Focusing on Revenue Integrity
04/12/2021
Vasilios Nassiopoulos
Holistic approaches to revenue integrity ensure that all billing and compliance functions are working collaboratively to address all sides of a claim.
Holistic approaches to revenue integrity ensure that all billing and compliance functions are working collaboratively to address all sides of a claim.
Holistic approaches to revenue...
04/12/2021
First Report Managed Care
News
AHA Urges HHS to Expedite COVID Vaccine Administration
04/12/2021
As the anniversary of the first US COVID-19 case approached, the American Hospital Association (AHA) wrote to former US Health and Human Services (HHS) Secretary Alex Azar urging the agency to become more transparent about the vaccine...
As the anniversary of the first US COVID-19 case approached, the American Hospital Association (AHA) wrote to former US Health and Human Services (HHS) Secretary Alex Azar urging the agency to become more transparent about the vaccine...
As the anniversary of the first...
04/12/2021
First Report Managed Care
News
CMS Rule Reduces Cost-Sharing, Increases Transparency for Medicare Advantage, Part D
04/12/2021
The Centers for Medicare & Medicaid Services (CMS) finalized a rule in an effort to improve both Medicare Advantage and Part D prescription drug programs.
The Centers for Medicare & Medicaid Services (CMS) finalized a rule in an effort to improve both Medicare Advantage and Part D prescription drug programs.
The Centers for Medicare &...
04/12/2021
First Report Managed Care
News
Trauma Patients Without Insurance Decreased After ACA, But Mortality Odds Increased
04/12/2021
Trauma patients covered by Medicare or Medicaid had improved mortality after implementation of the Patient Protection and Affordable Care Act (ACA) compared with before the ACA, but uninsured trauma patients did not. Researchers published...
Trauma patients covered by Medicare or Medicaid had improved mortality after implementation of the Patient Protection and Affordable Care Act (ACA) compared with before the ACA, but uninsured trauma patients did not. Researchers published...
Trauma patients covered by...
04/12/2021
First Report Managed Care
News
CMS Shares New SDoH Guidance and Strategies for Medicaid, CHIP
04/12/2021
Recently, the Centers for Medicare & Medicaid Services (CMS) shared new guidance with state health officials to better address social determinants of health (SDoH) for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. The...
Recently, the Centers for Medicare & Medicaid Services (CMS) shared new guidance with state health officials to better address social determinants of health (SDoH) for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. The...
Recently, the Centers for...
04/12/2021
First Report Managed Care
News
Association of ACA With Young Adult Females Seeking Sexual, Reproductive Health Services
04/12/2021
According to data published in JAMA Network Open, the implementation of the 2010 Patient Protection and Affordable Care Act Dependent Coverage Expansion (ACA-DCE) is associated with a reduction in insurance use for sexual and reproductive...
According to data published in JAMA Network Open, the implementation of the 2010 Patient Protection and Affordable Care Act Dependent Coverage Expansion (ACA-DCE) is associated with a reduction in insurance use for sexual and reproductive...
According to data published in...
04/12/2021
First Report Managed Care
Feature
Payer Expansion of Telehealth Initiatives
04/12/2021
Paul Nicolaus
As COVID-19 spurs expansion of payer telehealth offerings, some say initiatives begun during the pandemic could become the norm.
As COVID-19 spurs expansion of payer telehealth offerings, some say initiatives begun during the pandemic could become the norm.
As COVID-19 spurs expansion of...
04/12/2021
First Report Managed Care
Medicaid Expansion: Will Holdout States Take the Current Administration’s Bait?
04/12/2021
Dean Celia
The American Rescue Plan recently signed into law includes an incentive to encourage states to expand Medicaid. Will any of the 12 holdout states broaden their program for the needy, or do political divisions run so deep that compromise is...
The American Rescue Plan recently signed into law includes an incentive to encourage states to expand Medicaid. Will any of the 12 holdout states broaden their program for the needy, or do political divisions run so deep that compromise is...
The American Rescue Plan...
04/12/2021
First Report Managed Care

Pipeline Projections

PIPELINE PROJECTIONS
Emerging Therapies Reshaping Atopic Dermatitis Care
03/26/2026
Roy Moore
Roy Moore outlines how a rapidly expanding atopic dermatitis pipeline is intensifying competition, reshaping payer strategies, and raising the bar for new therapies.
Roy Moore outlines how a rapidly expanding atopic dermatitis pipeline is intensifying competition, reshaping payer strategies, and raising the bar for new therapies.
Roy Moore outlines how a rapidly...
03/26/2026
First Report Managed Care
Pipe
Pipeline Projections
Emerging Migraine Treatments Challenge a Mature Market
11/20/2025
Roy Moore
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market...
11/20/2025
First Report Managed Care
Pipeline Projections
Pipeline Projections
Redefining Asthma Management With Emerging Anti-Inflammatories
10/01/2025
Roy Moore
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access...
10/01/2025
First Report Managed Care
Pipeline Projections
The Shift in MS Care as Biologics and BTK Inhibitors Advance
07/25/2025
Roy Moore
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline...
07/25/2025
First Report Managed Care
Pipeline Projections
How Biosimilars Are Shaping RA Treatment and Reimbursement Strategies
04/29/2025
Roy Moore
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline...
04/29/2025
First Report Managed Care

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Behind the Bill

Behind the Bill
HHS Hits Reset on 340B Rebate Model After Court Setbacks
02/11/2026
Juliet Gallagher
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and...
02/11/2026
First Report Managed Care
Behind the Bill
Funding Package Extends Medicare Telehealth, Enacts PBM Reforms, and Updates Hospital Oversight
02/05/2026
Juliet Gallagher
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President...
02/05/2026
First Report Managed Care
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

April 2021 Volume 18 Issue 2

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