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Volume 18, Issue 5, July/August 2021 - First Report Managed Care

Cover Story
Managed Care Innovator: A Passion for Revenue Cycle Management
08/12/2021
Dean Celia
Diana Allen, PhD, took the helm at The SSI Group just as the COVID-19 pandemic was emerging. In an exclusive interview, she discusses what that was like, notes the critical need to educate patients about their financial obligation, and...
Diana Allen, PhD, took the helm at The SSI Group just as the COVID-19 pandemic was emerging. In an exclusive interview, she discusses what that was like, notes the critical need to educate patients about their financial obligation, and...
Diana Allen, PhD, took the helm...
08/12/2021
First Report Managed Care
Feature Story
The Coming Obesity Rx Cost Crisis
08/12/2021
Mary Beth Nierengarten
New treatments have been approved by the US Food & Drug Administration (FDA) for the treatment of obesity but payers covering these patient populations must now determine how to provide coverage and that begins with understanding the latest...
New treatments have been approved by the US Food & Drug Administration (FDA) for the treatment of obesity but payers covering these patient populations must now determine how to provide coverage and that begins with understanding the latest...
New treatments have been...
08/12/2021
First Report Managed Care
Literature Review
Examining Benefits of Cannabidiol for Patients With Seizures
08/12/2021
Edan Stanley
For the purpose of this literature review, we examine the latest data presented at the American Academy of Neurology’s (AAN) 2021 Virtual Annual Meeting regarding the use of CBD for patients with seizure disorders including TSC.  
For the purpose of this literature review, we examine the latest data presented at the American Academy of Neurology’s (AAN) 2021 Virtual Annual Meeting regarding the use of CBD for patients with seizure disorders including TSC.  
For the purpose of this...
08/12/2021
First Report Managed Care
Viewpoint
Health Care Is the Economy: A Perspective
08/12/2021
John G. Singer
“We are failing to reshape the American way of health care because the storyline of cost and price is perpetuating feedback loops that have not changed in more than 50 years,” says John G Singer, executive director of Blue Spoon Consulting.
“We are failing to reshape the American way of health care because the storyline of cost and price is perpetuating feedback loops that have not changed in more than 50 years,” says John G Singer, executive director of Blue Spoon Consulting.
“We are failing to reshape the...
08/12/2021
First Report Managed Care
Managed Care Q&A
Navigating Privacy, Stigma Concerns in At-Risk HIV Populations
08/12/2021
Edan Stanley
In order to end the HIV epidemic, payers and providers must work to improve uptake of pre-exposure prophylaxis (PrEP) among at-risk patient populations. In this interview, Edmund Pezalla, MD, MPH, CEO, Enlightenment Bioconsult, LLC, shares...
In order to end the HIV epidemic, payers and providers must work to improve uptake of pre-exposure prophylaxis (PrEP) among at-risk patient populations. In this interview, Edmund Pezalla, MD, MPH, CEO, Enlightenment Bioconsult, LLC, shares...
In order to end the HIV...
08/12/2021
First Report Managed Care
Managed Care Q&A
Insights Into a New Anticancer Therapy and What Payers Should Know
08/12/2021
Julie Gould
Matthew R Price, MBA, executive vice president and chief operating officer, Phosplatin Therapeutics, discusses the current pipeline of treatments at Phosplatin—highlighting their lead candidate, PT-112—and explains how they will engage with...
Matthew R Price, MBA, executive vice president and chief operating officer, Phosplatin Therapeutics, discusses the current pipeline of treatments at Phosplatin—highlighting their lead candidate, PT-112—and explains how they will engage with...
Matthew R Price, MBA, executive...
08/12/2021
First Report Managed Care
Commentary
Breaking Through the Social Determinants of Health Data Barriers
08/12/2021
Rahul P. Sharma, MD, MBBS, FRACP
“As providers and payers move deeper into population health and value-based case, one thing is clear—they need to be much more strategic in how they tackle social determinants of health,” says Rahul Sharma, CEO, HSBlox.
“As providers and payers move deeper into population health and value-based case, one thing is clear—they need to be much more strategic in how they tackle social determinants of health,” says Rahul Sharma, CEO, HSBlox.
“As providers and payers move...
08/12/2021
First Report Managed Care
Veterans Health Today
Improving Patient Outcomes and Lowering Treatment Costs for Veterans With DVT, PE
08/12/2021
Bernard Ross
Venous thromboembolism (VTE) incidents cause the death of up to 100,000 Americans every year. A new medical technology device has been approved for use on the Veterans Administration Federal Supply Schedule. In this commentary, Bernard Ross,...
Venous thromboembolism (VTE) incidents cause the death of up to 100,000 Americans every year. A new medical technology device has been approved for use on the Veterans Administration Federal Supply Schedule. In this commentary, Bernard Ross,...
Venous thromboembolism (VTE)...
08/12/2021
First Report Managed Care
News Connection
July 2021 Industry Updates
08/12/2021
News Connection features the latest industry updates from the July 2021 issue of First Report Managed Care.
News Connection features the latest industry updates from the July 2021 issue of First Report Managed Care.
News Connection features the...
08/12/2021
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

Trending Articles

News
Task Force Publishes Target-To-Treat Guidance for GCA and PMR
03/12/2024
Jolynn Tumolo
An international task force recently published the first target-to-treat (T2T) recommendations for patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in the Annals of the Rheumatic Diseases.
An international task force recently published the first target-to-treat (T2T) recommendations for patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in the Annals of the Rheumatic Diseases.
An international task force...
03/12/2024
First Report Managed Care
Asembia: More Than an Annual Conference
04/15/2024

Emry Lloyd

Emry Lloyd
Asembia, established in 2005, pioneered the recognition and promotion of specialty pharmacies, focusing on becoming a leader in the specialty pharmacy group purchasing organization sector. Offering scalable solutions, including prescription...
Asembia, established in 2005, pioneered the recognition and promotion of specialty pharmacies, focusing on becoming a leader in the specialty pharmacy group purchasing organization sector. Offering scalable solutions, including prescription...
Asembia, established in 2005,...
04/15/2024
First Report Managed Care
Conference Coverage
Addressing Suicidal Ideation in Persons With Multiple Sclerosis: Developing a Predictive Nomogram
05/22/2024
Hannah Musick
New research explored the development of a predictive nomogram to identify persons with multiple sclerosis at higher risk of suicidal ideation, emphasizing the importance of behavioral risk factors in this vulnerable population.
New research explored the development of a predictive nomogram to identify persons with multiple sclerosis at higher risk of suicidal ideation, emphasizing the importance of behavioral risk factors in this vulnerable population.
New research explored the...
05/22/2024
First Report Managed Care
News
Johnson & Johnson Expands Use of Prezcobix for Pediatric Patients in the US
06/21/2024
Hannah Musick
Johnson & Johnson aims to expand use of its HIV-1 therapy, Prezcobix, for younger patients in the US, potentially paving the way for improved treatment options for pediatric patients with the virus.
Johnson & Johnson aims to expand use of its HIV-1 therapy, Prezcobix, for younger patients in the US, potentially paving the way for improved treatment options for pediatric patients with the virus.
Johnson & Johnson aims to expand...
06/21/2024
First Report Managed Care
Brian Esterly Headshot
Interview
Insights on the 2024 Medicare Physician Fee Schedule: Implications and Opportunities for Virtual Care Management Services
07/26/2024
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician...
07/26/2024
First Report Managed Care

August 2021 Volume 18 Issue 5

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