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Yuri Fesko, MD, PAMA, Health Care Policy, Medicare
Interview
PAMA and the Downstream Impact of Lab Reimbursement on Cancer Care Access
01/22/2026
Yuri Fesko, MD
In this interview, senior vice president and chief medical officer at Quest Diagnostics, Yuri Fesko, MD, discusses how Medicare laboratory reimbursement under PAMA threatens access to precision cancer diagnostics—particularly for rural and...
In this interview, senior vice president and chief medical officer at Quest Diagnostics, Yuri Fesko, MD, discusses how Medicare laboratory reimbursement under PAMA threatens access to precision cancer diagnostics—particularly for rural and...
In this interview, senior vice...
01/22/2026
First Report Managed Care
Rural Hospitals, Behavioral Health, Coverage Gaps
Interview
Rural Hospitals on the Front Lines of Behavioral Health Coverage Gaps
01/15/2026
Shannon Werb
Shannon Werb, CEO of Array Behavioral Care, explains how uncertainty around Affordable Care Act (ACA) subsidies and Medicaid eligibility threatens to disrupt behavioral health care first—fueling treatment gaps, increased emergency department...
Shannon Werb, CEO of Array Behavioral Care, explains how uncertainty around Affordable Care Act (ACA) subsidies and Medicaid eligibility threatens to disrupt behavioral health care first—fueling treatment gaps, increased emergency department...
Shannon Werb, CEO of Array...
01/15/2026
First Report Managed Care
Interview
The Future of Medicaid: Standardized Data, Equitable Care, and AI-Powered Access
08/18/2025
Ryan Bullock
A health care executive from Aeroflow Health discusses how the Centers for Medicare & Medicaid Services (CMS)–driven push for interoperability standards, real-time patient data integration, expanded telehealth access, and the use of...
A health care executive from Aeroflow Health discusses how the Centers for Medicare & Medicaid Services (CMS)–driven push for interoperability standards, real-time patient data integration, expanded telehealth access, and the use of...
A health care executive from...
08/18/2025
First Report Managed Care
Phillips
Interview
Bridging the Gap: Policy, Equity, and Access in Urological Health
04/16/2025
Mica Phillips
Mica Phillips, executive vice president at Aeroflow Urology, discusses how economic, cultural, and systemic barriers limit access to incontinence care for minority populations, emphasizing the need for broader insurance coverage—including...
Mica Phillips, executive vice president at Aeroflow Urology, discusses how economic, cultural, and systemic barriers limit access to incontinence care for minority populations, emphasizing the need for broader insurance coverage—including...
Mica Phillips, executive vice...
04/16/2025
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
Alison Lum Headshot
Interview
Transforming Pharmacy Care and Drug Payment Models: Expert Insights From Asembia 2024
06/06/2024
Alison Lum, PharmD
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum, PharmD, vice president of Pharmacy Services at Blue Shield, discussed the panel she moderated at Asembia 2024 and delved into drug payment options' challenges, including the limitations of copay cards and the...
In this interview, Alison Lum,...
06/06/2024
First Report Managed Care
Calum Yacoubian Headshot
Interview
Navigating Medicare Advantage Risk Adjustment Plan Changes
01/09/2024
Calum Yacoubian, MD
Learn about significant changes in the Medicare Advantage Risk Adjustment model (transitioning from version 24 to 28) for payers and providers and the importance of accurate coding and the use of technologies like AI and natural language...
Learn about significant changes in the Medicare Advantage Risk Adjustment model (transitioning from version 24 to 28) for payers and providers and the importance of accurate coding and the use of technologies like AI and natural language...
Learn about significant changes...
01/09/2024
First Report Managed Care
Gould and Henry
Interview
Understanding the Implications of Medicare Advantage Growth
11/30/2023
Michael Gould; Cindy Henry
Learn about the growth of Medicare Advantage and its impact on the health care industry. Michael Gould and Cindy Henry discuss the popularity of Medicare Advantage plans, the potential effects of new regulations, and the importance of strong...
Learn about the growth of Medicare Advantage and its impact on the health care industry. Michael Gould and Cindy Henry discuss the popularity of Medicare Advantage plans, the potential effects of new regulations, and the importance of strong...
Learn about the growth of...
11/30/2023
First Report Managed Care
Headshot of Enam Noor, Insightin Health
Interview
How Health Plans Can Raise CAHPS Scores for Better Star Ratings
09/01/2022
Maria Asimopoulos
Enam Noor, CEO and founder, Insightin Health, shares advice for health plans to raise CAHPS scores and overall Star Ratings by consolidating data, reorganizing workflows, and improving member experience.
Enam Noor, CEO and founder, Insightin Health, shares advice for health plans to raise CAHPS scores and overall Star Ratings by consolidating data, reorganizing workflows, and improving member experience.
Enam Noor, CEO and founder,...
09/01/2022
First Report Managed Care
Headshot of Siran Koroukian, PhD, Case Western Reserve University
Interview
Cancer Prevalence in Male Medicaid Beneficiaries With HIV
03/29/2022
Maria Asimopoulos
Siran M Koroukian, PhD, professor, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, reviews findings from a cross-sectional study of national Medicaid data aimed at determining...
Siran M Koroukian, PhD, professor, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, reviews findings from a cross-sectional study of national Medicaid data aimed at determining...
Siran M Koroukian, PhD,...
03/29/2022
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
Balancing Medicare Advantage Denials for Patients With Diabetic Macular Edema
03/04/2024

Emry Lloyd

Emry Lloyd
Every year, millions of necessary medical service claims are denied by health care providers; policymakers want to balance these denials for those who need care and how this affects patients with diabetic macular edema.
Every year, millions of necessary medical service claims are denied by health care providers; policymakers want to balance these denials for those who need care and how this affects patients with diabetic macular edema.
Every year, millions of...
03/04/2024
First Report Managed Care
News
Study Finds Less Bacterial Diversity in Lashes of Patients With Demodex Blepharitis
04/11/2024
Jolynn Tumolo
Bacterial diversity is decreased in the eyelashes of patients with Demodex blepharitis compared with healthy volunteers, according to a study published online in Parasites & Vectors.
Bacterial diversity is decreased in the eyelashes of patients with Demodex blepharitis compared with healthy volunteers, according to a study published online in Parasites & Vectors.
Bacterial diversity is decreased...
04/11/2024
First Report Managed Care
Conference Coverage
Evolving Payer Strategies for Rare and Specialty Disease Management: Insights from Asembia 2024
05/20/2024
Matt Dickinson, PharmD, MBA, Alnylam Pharmaceuticals, led a panel to highlight payer strategies for managing rare and specialty disease products and how they continue to evolve based on Alnylam Pharmaceuticals’ 2023 Rare and Specialty Trend...
Matt Dickinson, PharmD, MBA, Alnylam Pharmaceuticals, led a panel to highlight payer strategies for managing rare and specialty disease products and how they continue to evolve based on Alnylam Pharmaceuticals’ 2023 Rare and Specialty Trend...
Matt Dickinson, PharmD, MBA,...
05/20/2024
First Report Managed Care
News
Comparing Rural and Urban HIV Risk Behaviors Among Adolescent Sexual Minority Males
06/11/2024
Hannah Musick
Research highlights differing HIV risk behaviors and service use between urban and rural adolescent sexual minority males in the US, emphasizing the need for targeted interventions to reduce infection rates in rural areas where access to...
Research highlights differing HIV risk behaviors and service use between urban and rural adolescent sexual minority males in the US, emphasizing the need for targeted interventions to reduce infection rates in rural areas where access to...
Research highlights differing...
06/11/2024
First Report Managed Care
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

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