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Vashi Headshot
Commentary
Optimizing Risk Adjustment and Quality Measurement With AI
09/15/2025
Deepan Vashi
As we’ve covered in the earlier entries in this series, artificial intelligence (AI) is proving useful in streamlining health plan operations of all sorts. AI tools can also augment human expertise for optimal results in less structured but...
As we’ve covered in the earlier entries in this series, artificial intelligence (AI) is proving useful in streamlining health plan operations of all sorts. AI tools can also augment human expertise for optimal results in less structured but...
As we’ve covered in the earlier...
09/15/2025
First Report Managed Care
Vashi
Commentary
Supercharging Digital Twins With Artificial Intelligence Tools
07/29/2025
Deepan Vashi
Digital twins are virtual models of processes, systems, and/or physical objects—including people. A digital twin uses data gathered from sensors, databases, wearables, and applications to simulate how its real-world twin operates. Twins can...
Digital twins are virtual models of processes, systems, and/or physical objects—including people. A digital twin uses data gathered from sensors, databases, wearables, and applications to simulate how its real-world twin operates. Twins can...
Digital twins are virtual models...
07/29/2025
First Report Managed Care
Fisher Headshot
Commentary
Deciphering Early Signals That Shape Future Therapies
07/07/2025
Ian Fisher
In today’s high-stakes, fast-paced environment for drug development, actions taken in the early stages of research and development (R&D) are shaping more than just clinical pathways. These decisions are helping define the future of drug...
In today’s high-stakes, fast-paced environment for drug development, actions taken in the early stages of research and development (R&D) are shaping more than just clinical pathways. These decisions are helping define the future of drug...
In today’s high-stakes,...
07/07/2025
First Report Managed Care
Vashi Headshot
Commentary
Transforming Appeals and Grievances With Multimodal and Agentic AI
06/17/2025
Deepan Vashi
Discover how leading health plans are using multimodal and agentic AI to transform appeals and grievances—cutting costs, improving compliance, and delivering faster decisions.
Discover how leading health plans are using multimodal and agentic AI to transform appeals and grievances—cutting costs, improving compliance, and delivering faster decisions.
Discover how leading health...
06/17/2025
First Report Managed Care
Vashi Headshot
Commentary
Revolutionizing Claims Operations With AI and Agentic Workflows
05/20/2025
Deepan Vashi
Autonomous AI agents and multiagent workflows are 2 key developments enabling payers to revamp current operations while building flexibility for adapting as health care evolves continues to shift toward outcomes-based models.
Autonomous AI agents and multiagent workflows are 2 key developments enabling payers to revamp current operations while building flexibility for adapting as health care evolves continues to shift toward outcomes-based models.
Autonomous AI agents and...
05/20/2025
First Report Managed Care
Jason Oswald Headshot
Commentary
The Impact of AI on Health Carrier Underwriting: Insights From Industry Experts
11/08/2024
"As AI continues to evolve, its integration into group health underwriting offers carriers new opportunities to enhance decision-making, streamline operations, and improve overall plan performance," said Jason Oswald, Director of Solution...
"As AI continues to evolve, its integration into group health underwriting offers carriers new opportunities to enhance decision-making, streamline operations, and improve overall plan performance," said Jason Oswald, Director of Solution...
"As AI continues to evolve, its...
11/08/2024
First Report Managed Care
Milo Headshot
Commentary
Transforming Health Care Payer Operations With AI
10/11/2024
Milosz (Milo) Wicinski
Health plans today face mounting pressure to enhance member engagement while improving health outcomes and control rising costs. As health care inflation continues to outpace general inflation across the United States, health plans are...
Health plans today face mounting pressure to enhance member engagement while improving health outcomes and control rising costs. As health care inflation continues to outpace general inflation across the United States, health plans are...
Health plans today face mounting...
10/11/2024
First Report Managed Care
Noel Felipe
Commentary
Providers Can Reduce Administrative Burden and Improve Productivity With AI Tools to Mitigate Labor Shortages
09/30/2024
Noel Felipe
As labor shortages continue to plague the health care industry, providers are turning to artificial intelligence tools to streamline administrative tasks, enhance patient care, and improve staff satisfaction, offering a glimpse into the...
As labor shortages continue to plague the health care industry, providers are turning to artificial intelligence tools to streamline administrative tasks, enhance patient care, and improve staff satisfaction, offering a glimpse into the...
As labor shortages continue to...
09/30/2024
First Report Managed Care
Commentary
Leveraging AI to Enhance the Member Experience for Health Plans
05/28/2024
Tim Price
The role of artificial intelligence (AI) is becoming increasingly significant, particularly in enhancing the customer experience for health plan members. Health plan executives have a unique opportunity to leverage AI’s potential, mirroring...
The role of artificial intelligence (AI) is becoming increasingly significant, particularly in enhancing the customer experience for health plan members. Health plan executives have a unique opportunity to leverage AI’s potential, mirroring...
The role of artificial...
05/28/2024
First Report Managed Care
Kevin/Avikar Hedshots
Commentary
From Data to Decision: How Generative AI is Shaping Patient Care Pathways
03/20/2024

Kevin Riley, CEO, President, Zyter|TruCare; Avikar Govil, Insights Health Product Manager, Zyter|TruCare

Kevin Riley, CEO, President, Zyter|Tr...
The rapid evolution of Generative Artificial Intelligence (Gen AI) is fundamentally transforming the health care industry, ushering in an era of increased personalization, efficiency, and improved patient outcomes. In this commentary, experts...
The rapid evolution of Generative Artificial Intelligence (Gen AI) is fundamentally transforming the health care industry, ushering in an era of increased personalization, efficiency, and improved patient outcomes. In this commentary, experts...
The rapid evolution of...
03/20/2024
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

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Trending Articles

News
Satellite Data Reveals a Link Between NO2 Exposure and Asthma Exacerbations
10/02/2023
Lisa Kuhns, PhD, MD
Incorporating ground-level satellite-derived estimates of NO2 into multivariable models reveals a relationship between NO2 exposure and asthma exacerbations, according to a study published in AMIA Joint Summits on Translational Science.
Incorporating ground-level satellite-derived estimates of NO2 into multivariable models reveals a relationship between NO2 exposure and asthma exacerbations, according to a study published in AMIA Joint Summits on Translational Science.
Incorporating ground-level...
10/02/2023
First Report Managed Care
News
Biosimilars: Uptake and Pricing in the US, Germany, and Switzerland
10/20/2023
Danielle Sposato
Various countries have implemented policies and regulatory pathways, such as the US's Biological Price Competition and Innovation Act and a similar approval pathway in the European Union, to facilitate the entry of biosimilars. This study...
Various countries have implemented policies and regulatory pathways, such as the US's Biological Price Competition and Innovation Act and a similar approval pathway in the European Union, to facilitate the entry of biosimilars. This study...
Various countries have...
10/20/2023
First Report Managed Care
Commentary
Review Provides Insight Into FDA Regulations and Prescription Digital Therapeutics as Market Expands
11/09/2023
Yvette C. Terrie, BS Pharm, RPh
As the number of PDTs continues to enter the market, it is important that clinicians and patients are aware of the regulatory processes instituted by the FDA to ensure the efficacy and safety of PDTs, and knowledge about the meticulous and...
As the number of PDTs continues to enter the market, it is important that clinicians and patients are aware of the regulatory processes instituted by the FDA to ensure the efficacy and safety of PDTs, and knowledge about the meticulous and...
As the number of PDTs continues...
11/09/2023
First Report Managed Care
Quiz
Utilization and Spending Changes With Preventive Drug Lists
12/12/2023
True or False: A case-control study found that exempting asthma medications from the deductible through preventive drug lists was associated with a modest absolute increase in adherence to controller medications and significantly reduced...
True or False: A case-control study found that exempting asthma medications from the deductible through preventive drug lists was associated with a modest absolute increase in adherence to controller medications and significantly reduced...
True or False: A case-control...
12/12/2023
First Report Managed Care
KOL Headshots
Commentary
2024 Predictions: Key Trends Identified by Business Leaders and Health Care Experts in Value-Based Care
01/23/2024
In this exclusive commentary for First Report Managed Care, health experts and business leaders share insights into predictions for the 2024 value-based care landscape. Insights highlight trends in behavioral health, AI integration,...
In this exclusive commentary for First Report Managed Care, health experts and business leaders share insights into predictions for the 2024 value-based care landscape. Insights highlight trends in behavioral health, AI integration,...
In this exclusive commentary for...
01/23/2024
First Report Managed Care

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