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News
Survey Finds Widespread Use of Shadow AI in US Health Care
01/26/2026
Juliet Gallagher
Health care workers across the United States are increasingly using artificial intelligence tools that have not been approved by their organizations, raising concerns about patient safety and data security. According to a new survey published...
Health care workers across the United States are increasingly using artificial intelligence tools that have not been approved by their organizations, raising concerns about patient safety and data security. According to a new survey published...
Health care workers across the...
01/26/2026
First Report Managed Care
News
US Senator Urges EHR Vendors to Expand Patient Data Controls
01/20/2026
Hannah Musick
A US senator is urging electronic health record vendors to adopt patient-facing controls that limit who can access medical data, aiming to strengthen cybersecurity while preserving interoperability.
A US senator is urging electronic health record vendors to adopt patient-facing controls that limit who can access medical data, aiming to strengthen cybersecurity while preserving interoperability.
A US senator is urging...
01/20/2026
First Report Managed Care
News
Marketplace Open Enrollment Tops 22.8 Million Selections for 2026 Coverage
01/16/2026
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) reports that nearly 22.8 million Americans selected 2026 Marketplace health plans during open enrollment, underscoring continued demand for Affordable Care Act (ACA) coverage across federal...
The Centers for Medicare & Medicaid Services (CMS) reports that nearly 22.8 million Americans selected 2026 Marketplace health plans during open enrollment, underscoring continued demand for Affordable Care Act (ACA) coverage across federal...
The Centers for Medicare &...
01/16/2026
First Report Managed Care
News
CMS Launches BALANCE Model to Expand GLP-1 Coverage in US
01/13/2026
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) has launched a new voluntary model that could reshape GLP-1 access nationwide by lowering prices, standardizing coverage, and integrating lifestyle care across Medicare Part D and Medicaid.
The Centers for Medicare & Medicaid Services (CMS) has launched a new voluntary model that could reshape GLP-1 access nationwide by lowering prices, standardizing coverage, and integrating lifestyle care across Medicare Part D and Medicaid.
The Centers for Medicare &...
01/13/2026
First Report Managed Care
News
Johnson & Johnson Reaches US Drug Pricing Agreement With Trump Administration
01/09/2026
Grace Taylor, MS, MA
Johnson & Johnson has struck a voluntary agreement with the Trump Administration to lower US drug prices, expand patient access, and accelerate billions in domestic pharmaceutical manufacturing investments.
Johnson & Johnson has struck a voluntary agreement with the Trump Administration to lower US drug prices, expand patient access, and accelerate billions in domestic pharmaceutical manufacturing investments.
Johnson & Johnson has struck a...
01/09/2026
First Report Managed Care
News
Independence Health System to Join WVU Medicine in Major Regional Integration
11/25/2025
Juliet Gallagher
Independence Health System, a five-hospital network serving western Pennsylvania, announced plans to join the West Virginia University Health System (WVU Medicine) in fall 2026. The move, disclosed Wednesday, will bring Independence’s...
Independence Health System, a five-hospital network serving western Pennsylvania, announced plans to join the West Virginia University Health System (WVU Medicine) in fall 2026. The move, disclosed Wednesday, will bring Independence’s...
Independence Health System, a...
11/25/2025
First Report Managed Care
News
Global Integrated Delivery Network Market to Surpass $34 Billion by 2034
11/17/2025
Lisa Kuhns, PhD, MD
The global integrated delivery network (IDN) market is set for robust expansion, projected to grow from USD 13.41 billion in 2025 to USD 34.05 billion by 2034, at a compound annual growth rate (CAGR) of 10.91%.
The global integrated delivery network (IDN) market is set for robust expansion, projected to grow from USD 13.41 billion in 2025 to USD 34.05 billion by 2034, at a compound annual growth rate (CAGR) of 10.91%.
The global integrated delivery...
11/17/2025
First Report Managed Care
News
All 50 States Apply for CMS’s $50 Billion Rural Health Transformation Fund
11/14/2025
Hannah Musick
All 50 US states have applied for CMS’s new $50 billion Rural Health Transformation Program, a 5-year initiative to strengthen rural health care access, workforce capacity, and digital infrastructure beginning in 2026.
All 50 US states have applied for CMS’s new $50 billion Rural Health Transformation Program, a 5-year initiative to strengthen rural health care access, workforce capacity, and digital infrastructure beginning in 2026.
All 50 US states have applied...
11/14/2025
First Report Managed Care
News
Health Care AI Adoption Requires Transparency, Policy Upgrades, and Cybersecurity
11/11/2025
Hannah Musick
A new global review finds that while artificial intelligence (AI) is transforming health care through advanced diagnostics and automation, its safe adoption will depend on transparency in algorithm design, stronger cybersecurity measures, and...
A new global review finds that while artificial intelligence (AI) is transforming health care through advanced diagnostics and automation, its safe adoption will depend on transparency in algorithm design, stronger cybersecurity measures, and...
A new global review finds that...
11/11/2025
First Report Managed Care
News
Accountable Care Organizations Deliver $6.5 Billion in Medicare Savings, Boosting Value-Based Care Momentum
11/04/2025
Juliet Gallagher
The Centers for Medicare & Medicaid Services (CMS) announced record results for the Medicare Shared Savings Program (MSSP) in 2024, marking its most successful year since the program’s launch over a decade ago. The initiative generated $6.5...
The Centers for Medicare & Medicaid Services (CMS) announced record results for the Medicare Shared Savings Program (MSSP) in 2024, marking its most successful year since the program’s launch over a decade ago. The initiative generated $6.5...
The Centers for Medicare &...
11/04/2025
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

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

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