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News
Co-occurring ADHD Associated With Poorer Health Outcomes in Adults With Autism on Medicaid
02/02/2026
Grace Taylor, MS, MA
A large US Medicaid study finds that co-occurring attention-deficit/hyperactivity disorder (ADHD) is common among adults with autism and is linked to higher rates of substance use, cardiovascular conditions, and injury, while ADHD medication...
A large US Medicaid study finds that co-occurring attention-deficit/hyperactivity disorder (ADHD) is common among adults with autism and is linked to higher rates of substance use, cardiovascular conditions, and injury, while ADHD medication...
A large US Medicaid study finds...
02/02/2026
First Report Managed Care
News
Study Projects Billions in Savings From Site-Neutral Payments for Routine Services
01/23/2026
Grace Taylor, MS, MA
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.
A national analysis of 2022...
01/23/2026
First Report Managed Care
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
News
Medicare Part D Formularies Remain Broad for IRA-Negotiated Drugs
01/20/2026
Grace Taylor, MS, MA
Despite broad Medicare Part D coverage for Inflation Reduction Act (IRA)-negotiated drugs, data suggest formulary access is narrowing for non-selected therapies—particularly orphan drugs—raising concerns about patient access as price...
Despite broad Medicare Part D coverage for Inflation Reduction Act (IRA)-negotiated drugs, data suggest formulary access is narrowing for non-selected therapies—particularly orphan drugs—raising concerns about patient access as price...
Despite broad Medicare Part D...
01/20/2026
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
News
AI Navigator Launched to Support Medicaid and SNAP Members Amid Policy Shifts
12/22/2025
Hannah Musick
Social health platform Pyx Health has launched an AI-driven navigator aimed at helping US Medicaid and Supplemental Nutrition Assistance Program (SNAP) beneficiaries comply with new policy requirements under the One Big Beautiful Bill Act...
Social health platform Pyx Health has launched an AI-driven navigator aimed at helping US Medicaid and Supplemental Nutrition Assistance Program (SNAP) beneficiaries comply with new policy requirements under the One Big Beautiful Bill Act...
Social health platform Pyx...
12/22/2025
First Report Managed Care
News
CMS Unveils LEAD Model to Succeed ACO REACH in 2027
12/19/2025
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) is set to replace the Accountable Care Organization (ACO) REACH model with its longest-ever accountable care demonstration, a 10-year Long-Term Enhanced ACO Design (LEAD) model aimed at...
The Centers for Medicare & Medicaid Services (CMS) is set to replace the Accountable Care Organization (ACO) REACH model with its longest-ever accountable care demonstration, a 10-year Long-Term Enhanced ACO Design (LEAD) model aimed at...
The Centers for Medicare &...
12/19/2025
First Report Managed Care
News
A New Era for Medicaid: CMS Unveils the Blueprint for Engagement, Integrity, and Sustainability
12/09/2025
Danielle Sposato
The Centers for Medicare & Medicaid Services (CMS) released new guidance detailing how states should implement major Medicaid reforms included in the Working Families Tax Cut (WFTC) legislation (Public Law 119-21). These reforms mark some of...
The Centers for Medicare & Medicaid Services (CMS) released new guidance detailing how states should implement major Medicaid reforms included in the Working Families Tax Cut (WFTC) legislation (Public Law 119-21). These reforms mark some of...
The Centers for Medicare &...
12/09/2025
First Report Managed Care
News
CMS Issues New Guidance to Tighten Oversight of Medicaid Financing
11/18/2025
Juliet Gallagher
The Centers for Medicare & Medicaid Services (CMS) released preliminary guidance to states on implementing new federal limits on Medicaid health care-related taxes and closing financing loopholes. The guidance, stemming from the Working...
The Centers for Medicare & Medicaid Services (CMS) released preliminary guidance to states on implementing new federal limits on Medicaid health care-related taxes and closing financing loopholes. The guidance, stemming from the Working...
The Centers for Medicare &...
11/18/2025
First Report Managed Care
News
CMS Announces 2026 Medicare Premiums and Deductibles: Moderate Increases Across Parts A, B, and D
11/17/2025
Juliet Gallagher
On November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) announced the 2026 Medicare Parts A and B premiums, deductibles, and coinsurance rates, along with the updated income-related monthly adjustment amounts for Part D. The...
On November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) announced the 2026 Medicare Parts A and B premiums, deductibles, and coinsurance rates, along with the updated income-related monthly adjustment amounts for Part D. The...
On November 14, 2025, the...
11/17/2025
First Report Managed Care
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