A national analysis of 2022 commercial claims data suggests that capping payments for routine services at site-neutral Medicare-based rates could save purchasers and patients $10.8 billion annually with only modest effects on hospital margins.
A national analysis of 2022 commercial claims data suggests that capping payments for routine services at site-neutral Medicare-based rates could save purchasers and patients $10.8 billion annually with only modest effects on hospital margins.
The Drug Enforcement Administration (DEA), jointly with the Department of Health and Human Services (HHS), has issued a Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for the Prescription of Controlled Medications. The...
The Drug Enforcement Administration (DEA), jointly with the Department of Health and Human Services (HHS), has issued a Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for the Prescription of Controlled Medications. The...
Hospitals are facing rising financial pressure as denial amounts and payer audits continue to climb in 2025, signaling an unsustainable trend for many health systems, according to a new report from billing compliance and revenue integrity...
Hospitals are facing rising financial pressure as denial amounts and payer audits continue to climb in 2025, signaling an unsustainable trend for many health systems, according to a new report from billing compliance and revenue integrity...
Americans across political party lines overwhelmingly support stronger protections against medical debt, signaling rare consensus in a politically polarized era, according to a survey conducted by Undue Medical Debt. That is the clear...
Americans across political party lines overwhelmingly support stronger protections against medical debt, signaling rare consensus in a politically polarized era, according to a survey conducted by Undue Medical Debt. That is the clear...
The Health Resources and Services Administration (HRSA) has approved 8 pharmaceutical manufacturer proposals to issue rebates under the 340B Drug Pricing Program, marking a significant departure from the long-standing model of upfront...
The Health Resources and Services Administration (HRSA) has approved 8 pharmaceutical manufacturer proposals to issue rebates under the 340B Drug Pricing Program, marking a significant departure from the long-standing model of upfront...
At AMCP Nexus 2025, Autumn D. Zuckerman, PharmD, BCPS, CSP, joined by Amy Niles, MBA, and Ashira Vantrees, Esq., unpacked 3 cost-shifting strategies that are reshaping access to specialty medicines: copay accumulators, copay maximizers, and...
At AMCP Nexus 2025, Autumn D. Zuckerman, PharmD, BCPS, CSP, joined by Amy Niles, MBA, and Ashira Vantrees, Esq., unpacked 3 cost-shifting strategies that are reshaping access to specialty medicines: copay accumulators, copay maximizers, and...
UnitedHealthcare is reimagining the member experience with the launch of UHC Store, a new digital marketplace designed to help more than 6 million commercial members shop for personalized health and wellness offerings, a number expected to...
UnitedHealthcare is reimagining the member experience with the launch of UHC Store, a new digital marketplace designed to help more than 6 million commercial members shop for personalized health and wellness offerings, a number expected to...
The therapeutic landscape of chronic lymphocytic leukemia (CLL) continues to expand, offering patients and providers more flexibility than ever before. In a recent discussion with First Report Managed Care, Sameh Gaballa, MD, associate member...
The therapeutic landscape of chronic lymphocytic leukemia (CLL) continues to expand, offering patients and providers more flexibility than ever before. In a recent discussion with First Report Managed Care, Sameh Gaballa, MD, associate member...
A new analysis from the Kaiser Family Foundation (KFF) warns that premiums for Affordable Care Act (ACA) marketplace plans could more than double in 2026 if enhanced federal subsidies expire at the end of this year. The report highlights the...
A new analysis from the Kaiser Family Foundation (KFF) warns that premiums for Affordable Care Act (ACA) marketplace plans could more than double in 2026 if enhanced federal subsidies expire at the end of this year. The report highlights the...
Adam J. Fein, PhD, founder and President of Drug Channels Institute, has previewed highlights from the forthcoming 2025–26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors in his blog post, Inside the 2025 PSAO Market:...
Adam J. Fein, PhD, founder and President of Drug Channels Institute, has previewed highlights from the forthcoming 2025–26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors in his blog post, Inside the 2025 PSAO Market:...
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, 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...
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 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 Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate and Editorial Board Member of First Report Managed Care—explores newly approved and existing anticoagulant therapies. He analyzes...
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate and Editorial Board Member of First Report Managed Care—explores newly approved and existing anticoagulant therapies. He analyzes...
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...
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...
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...
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...
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...
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,...
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...
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...
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 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...
