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Regulatory Insights
Subsidies, Savings, and Stalemates: What Congress's Year-End Gridlock Means for Health Plans in 2026
12/05/2025
Adam Colborn, JD
As health policy debates resurface in Washington, unresolved battles over ACA subsidies, health savings accounts, and PBM reform are shaping a high-stakes landscape for payers heading into the new year.
As health policy debates resurface in Washington, unresolved battles over ACA subsidies, health savings accounts, and PBM reform are shaping a high-stakes landscape for payers heading into the new year.
As health policy debates...
12/05/2025
First Report Managed Care
Cell & Gene Watch
Reaching Patients Where They Are: Moving CGT Care into the Community
12/05/2025
Joe DePinto
As cell and gene therapies rapidly advance, shrinking the nation’s growing “CGT deserts” by expanding capabilities in community care settings is essential to ensure that breakthrough treatments reach patients equitably—not just those living...
As cell and gene therapies rapidly advance, shrinking the nation’s growing “CGT deserts” by expanding capabilities in community care settings is essential to ensure that breakthrough treatments reach patients equitably—not just those living...
As cell and gene therapies...
12/05/2025
First Report Managed Care
MANAGED CARE Q&A
SDOH Interventions and Managed Care Performance: A Roadmap for Health Plans
12/05/2025
Karen Iapoce, RNC, MSN, CPHQ, LSSBB
Karen Iapoce explains how integrating social determinants of health into managed care workflows can drive measurable improvements in outcomes and Stars performance.
Karen Iapoce explains how integrating social determinants of health into managed care workflows can drive measurable improvements in outcomes and Stars performance.
Karen Iapoce explains how...
12/05/2025
First Report Managed Care
MANAGED CARE Q&A
Turning Data into Equity: How Advanced Analytics and SDOH Integration Are Redefining Value-Based Care
11/25/2025
Michael Hoxter
Michael Hoxter, Chief Technology Officer at Lightbeam Health Solutions, discusses how advanced analytics, artificial intelligence (AI), and social determinants of health data are transforming population health management, driving efficiency,...
Michael Hoxter, Chief Technology Officer at Lightbeam Health Solutions, discusses how advanced analytics, artificial intelligence (AI), and social determinants of health data are transforming population health management, driving efficiency,...
Michael Hoxter, Chief Technology...
11/25/2025
First Report Managed Care
MANAGED CARE Q&A
Right-Sizing Star Ratings: How Health Plans Can Adapt to a Changing Landscape
11/25/2025
Marge Ciancetta
Cotiviti’s Marge Ciancetta highlights how mid-sized Medicare Advantage plans leverage local insight, operational agility, and innovation to outperform larger national competitors.
Cotiviti’s Marge Ciancetta highlights how mid-sized Medicare Advantage plans leverage local insight, operational agility, and innovation to outperform larger national competitors.
Cotiviti’s Marge Ciancetta...
11/25/2025
First Report Managed Care
MANAGED CARE Q&A
The Potential of AI as a Clinical Co‑Pilot
11/24/2025
Gregory Whisman, MD, MBA
A guest expert explores how artificial intelligence is emerging as a clinical co-pilot by streamlining administrative burdens, enhancing patient targeting and engagement, and supporting predictive care strategies to improve quality, reduce...
A guest expert explores how artificial intelligence is emerging as a clinical co-pilot by streamlining administrative burdens, enhancing patient targeting and engagement, and supporting predictive care strategies to improve quality, reduce...
A guest expert explores how...
11/24/2025
First Report Managed Care
Commentary
Biologics: Combating Big Spend in Small Doses
11/24/2025
Krithika Srivats
A guest expert discusses how biologic drugs like monoclonal antibodies are driving soaring health care costs, but data-driven strategies and greater use of biosimilars may offer payers a powerful path to rein in spending without compromising...
A guest expert discusses how biologic drugs like monoclonal antibodies are driving soaring health care costs, but data-driven strategies and greater use of biosimilars may offer payers a powerful path to rein in spending without compromising...
A guest expert discusses how...
11/24/2025
First Report Managed Care
Subhead

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

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
News
Dietary Patterns May Reshape Microbiota to Combat Obesity
08/19/2024
Lisa Kuhns, PhD, MD
Dietary patterns that promote beneficial gut microbiota show promise in combating obesity and related metabolic diseases, according to recent research published in Frontiers in Nutrition.
Dietary patterns that promote beneficial gut microbiota show promise in combating obesity and related metabolic diseases, according to recent research published in Frontiers in Nutrition.
Dietary patterns that promote...
08/19/2024
First Report Managed Care
News
High Mortality and Impairment Rates Among Older Adults in Long-Term Acute Care Hospitals
09/20/2024
Lisa Kuhns, PhD, MD
Long-term acute care hospitals (LTCHs) provide critical, multidisciplinary care for medically complex patients, but survival rates and long-term functional outcomes remain poor, according to a study published in JAMA Network Open.
Long-term acute care hospitals (LTCHs) provide critical, multidisciplinary care for medically complex patients, but survival rates and long-term functional outcomes remain poor, according to a study published in JAMA Network Open.
Long-term acute care hospitals...
09/20/2024
First Report Managed Care
Conference Coverage
Assessing the Effectiveness of DTBZ in Promoting Psychiatric Stability in Patients With Tardive Dyskinesia
10/14/2024
Hannah Musick
Research presented at AMCP Nexus 2024 examines the impact of deutetrabenazine (DTBZ) on psychiatric stability in patients with tardive dyskinesia, showing a potential improvement in schizophrenia-related hospitalizations and emergency...
Research presented at AMCP Nexus 2024 examines the impact of deutetrabenazine (DTBZ) on psychiatric stability in patients with tardive dyskinesia, showing a potential improvement in schizophrenia-related hospitalizations and emergency...
Research presented at AMCP Nexus...
10/14/2024
First Report Managed Care
News
Impact of Immune Checkpoint Inhibitors on Multiple Sclerosis Treatment Outcomes
10/29/2024
Grace Taylor, MS, MA
Relapses and progression of multiple sclerosis were rare in patients treated with immune checkpoint inhibitors, according to a study presented at the American Academy of Neurology 2024 Annual Meeting.
Relapses and progression of multiple sclerosis were rare in patients treated with immune checkpoint inhibitors, according to a study presented at the American Academy of Neurology 2024 Annual Meeting.
Relapses and progression of...
10/29/2024
First Report Managed Care

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