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Volume 17, Issue 7, August 2020 - First Report Managed Care

Featured Article

Is Capitation Making a Comeback?
08/13/2020
In the face of plummeting provider reimbursement due to the COVID-19 pandemic, fixed-fee pay models are getting a closer look. First Report Managed Care consulted an expert panel about capitation’s pros and cons, whether it has staying power,...
In the face of plummeting provider reimbursement due to the COVID-19 pandemic, fixed-fee pay models are getting a closer look. First Report Managed Care consulted an expert panel about capitation’s pros and cons, whether it has staying power,...
In the face of plummeting...
08/13/2020
First Report Managed Care

Special Report

First Report
HEOR First Report: A Deeper Look at the Benefits of Hemlibra
08/31/2020
Karen Powell, PharmD, MS, Pharmacy Solutions Coordinator, Conduent, discusses a recent study in which she and her colleagues measured the cost effectiveness and utilizations rates associated with emicizumab-kxwh treatment for patients with...
Karen Powell, PharmD, MS, Pharmacy Solutions Coordinator, Conduent, discusses a recent study in which she and her colleagues measured the cost effectiveness and utilizations rates associated with emicizumab-kxwh treatment for patients with...
Karen Powell, PharmD, MS,...
08/31/2020
First Report Managed Care
First Report
Decreased Medication, Utilization Costs Identified With Emicizumab-kxwh Therapy for Hemophilia
08/31/2020
Emicizumab-kxwh, which was approved by the FDA in November 2017 to prevent or reduce the frequency of bleeding episodes in patients with hemophilia (HEM) A and FVIII inhibitors, was found to be associated with decreased medication and...
Emicizumab-kxwh, which was approved by the FDA in November 2017 to prevent or reduce the frequency of bleeding episodes in patients with hemophilia (HEM) A and FVIII inhibitors, was found to be associated with decreased medication and...
Emicizumab-kxwh, which was...
08/31/2020
First Report Managed Care

Department

Formulary Frontlines®
Migraine and Payer Management Challenges
08/31/2020
Headache is extremely common in the general population, but despite its high prevalence and impairment, migraine is often not recognized or effectively treated. Because new classes of drugs and nondrug treatments continue to surface, more...
Headache is extremely common in the general population, but despite its high prevalence and impairment, migraine is often not recognized or effectively treated. Because new classes of drugs and nondrug treatments continue to surface, more...
Headache is extremely common in...
08/31/2020
First Report Managed Care
Veterans Health Today
Recognizing Causes of Alcohol Use Disorder
08/31/2020
Lifetime drug use disorder, greater alcohol use at baseline, and trauma-related characteristics were independently associated with developing alcohol use disorder within 7 years of follow-up in US military veterans, according to a study...
Lifetime drug use disorder, greater alcohol use at baseline, and trauma-related characteristics were independently associated with developing alcohol use disorder within 7 years of follow-up in US military veterans, according to a study...
Lifetime drug use disorder,...
08/31/2020
First Report Managed Care
Veterans Health Today
To Reduce Suicide Risk in Veterans, Efforts Must Include Functioning, Well-being
08/31/2020
Mental health services to reduce suicide risk among US veterans should focus on maintaining or improving basic functioning (living, financial, and vocational) and well-being (social, psychological, and spiritual), suggests findings from a...
Mental health services to reduce suicide risk among US veterans should focus on maintaining or improving basic functioning (living, financial, and vocational) and well-being (social, psychological, and spiritual), suggests findings from a...
Mental health services to reduce...
08/31/2020
First Report Managed Care
Veterans Health Today
Group-Based Integrative Health Program Improves Mental Health, Pain in Female Veterans
08/31/2020
Participation in a group-based complementary and integrative health program significantly improved self-reported mental health and pain interfering with work in a pilot sample of female veterans, according to a study published in Explore. 
Participation in a group-based complementary and integrative health program significantly improved self-reported mental health and pain interfering with work in a pilot sample of female veterans, according to a study published in Explore. 
Participation in a group-based...
08/31/2020
First Report Managed Care

Column

Viewpoint
Three Steps to Identify and Address Social Determinants of Health
08/31/2020
Social determinants of health (SDoH) reflect a wide variety of factors, including where people live, their education level, their occupation, and their ability to access support networks.
Social determinants of health (SDoH) reflect a wide variety of factors, including where people live, their education level, their occupation, and their ability to access support networks.
Social determinants of health...
08/31/2020
First Report Managed Care

Insights

Commentary
How Health Care Organizations Can Counter Vaccine Hesitancy
08/31/2020
The advent of the COVID-19 public health crisis has surfaced many challenges—both old and new—for the health care industry. It’s catalyzed us to re-examine the disparities in health care for minority groups; the future of telehealth as a...
The advent of the COVID-19 public health crisis has surfaced many challenges—both old and new—for the health care industry. It’s catalyzed us to re-examine the disparities in health care for minority groups; the future of telehealth as a...
The advent of the COVID-19...
08/31/2020
First Report Managed Care
Commentary
How Physicians Lead Through a Crisis
08/31/2020
Since late February 2020, the novel coronavirus has been the single item on our agenda as we debrief internally what has since consumed every facet of leading a health care provider organization.
Since late February 2020, the novel coronavirus has been the single item on our agenda as we debrief internally what has since consumed every facet of leading a health care provider organization.
Since late February 2020, the...
08/31/2020
First Report Managed Care
Integrated Healthcare Executive
Improving Processes Within Health Care Systems Through AI, Natural Language Processing
08/31/2020
Integrated Healthcare Executive recently spoke with Joe Ferro, president of abeo Technology Solutions and founder of TRUSTEDi10, regarding the use of artificial intelligence (AI) and natural language processing within health care systems.
Integrated Healthcare Executive recently spoke with Joe Ferro, president of abeo Technology Solutions and founder of TRUSTEDi10, regarding the use of artificial intelligence (AI) and natural language processing within health care systems.
Integrated Healthcare Executive...
08/31/2020
First Report Managed Care

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News
Aetna Exits Iowa Individual Insurance Market for 2018
04/06/2017
Due to uncertainty over the fate of the ACA marketplace, Aetna recently announced it will exit Iowa's individual market.
Due to uncertainty over the fate of the ACA marketplace, Aetna recently announced it will exit Iowa's individual market.
Due to uncertainty over the fate...
04/06/2017
First Report Managed Care
News
Study Finds Inverse Correlation Between Endothelial Function and Depression in PsA
09/30/2021
“If validated in longitudinal studies, this evidence would encourage a systematic research of depressive symptoms as a part of a correct assessment of cardiovascular risk in PsA,” researchers wrote, “helping to raise the effectiveness of...
“If validated in longitudinal studies, this evidence would encourage a systematic research of depressive symptoms as a part of a correct assessment of cardiovascular risk in PsA,” researchers wrote, “helping to raise the effectiveness of...
“If validated in longitudinal...
09/30/2021
First Report Managed Care
Enoxaparin in Patients with Moderate Renal Impairment
07/22/2013
Enoxaparin sodium, a heparin with a low molecular weight, allows for simplified dosing without the need for vigilant monitoring through laboratory tests.
Enoxaparin sodium, a heparin with a low molecular weight, allows for simplified dosing without the need for vigilant monitoring through laboratory tests.
Enoxaparin sodium, a heparin...
07/22/2013
First Report Managed Care
News
15 States Try To Cut Back On Medicaid Programs
06/08/2011
06/08/2011
First Report Managed Care
News
Orphan Drug Approvals Increasing
02/13/2014
New York—Of the 27 FDA-approved drugs in 2013, 9 were for rare diseases and granted orphan status, indicating they are for diseases affecting 200,000 or fewer people in the United States. With more than 7,000 rare diseases and the increasing...
New York—Of the 27 FDA-approved drugs in 2013, 9 were for rare diseases and granted orphan status, indicating they are for diseases affecting 200,000 or fewer people in the United States. With more than 7,000 rare diseases and the increasing...
New York—Of the 27 FDA-approved...
02/13/2014
First Report Managed Care

Video Insights

Videos
Bridging the Gaps in Prior Authorization: Challenges, Solutions, and Collaboration for Better Patient Care
11/13/2024
David Sand, MD, MBA, chief medical officer at ZeOmega, discusses the challenges of prior authorization, emphasizing the need for transparency, evidence-based standards, collaboration between payers and providers, and the potential for...
David Sand, MD, MBA, chief medical officer at ZeOmega, discusses the challenges of prior authorization, emphasizing the need for transparency, evidence-based standards, collaboration between payers and providers, and the potential for...
David Sand, MD, MBA, chief...
11/13/2024
First Report Managed Care
Richard Lipton, MD
Videos
The Evolving Role of CGRP-targeting Therapies in Migraine Prevention
10/31/2024
Richard Lipton, MD, provides insights on the American Headache Society’s position statement update on calcitonin gene-related peptide (CGRP)-targeting therapies as a first-line option for the prevention of migraine.
Richard Lipton, MD, provides insights on the American Headache Society’s position statement update on calcitonin gene-related peptide (CGRP)-targeting therapies as a first-line option for the prevention of migraine.
Richard Lipton, MD, provides...
10/31/2024
First Report Managed Care
Alexander Spira, MD, PhD
Videos
Unmet Needs in the Treatment and Management of Non–Small Cell Lung Cancer
09/26/2024
Alexander I. Spira, MD, PhD, discusses significant unmet needs in the treatment and management of non–small cell lung cancer (NSCLC).
Alexander I. Spira, MD, PhD, discusses significant unmet needs in the treatment and management of non–small cell lung cancer (NSCLC).
Alexander I. Spira, MD, PhD,...
09/26/2024
First Report Managed Care
Videos
Treatment Options for NSCLC: A Discussion on Coverage, Clinical Outcomes, and Payer Perspectives
09/25/2024
Learn about research developments in 1L therapy for NSCLC patients with EGFR mutations and how outcomes may impact coverage and reimbursement decisions for insurers.
Learn about research developments in 1L therapy for NSCLC patients with EGFR mutations and how outcomes may impact coverage and reimbursement decisions for insurers.
Learn about research...
09/25/2024
First Report Managed Care
Title Card
Videos
Addressing the Root Cause of a Common Ocular Condition: A Virtual Roundtable
09/04/2024
View a roundtable discussion on Demodex blepharitis, a prevalent ocular condition that often goes undiagnosed in patients.
View a roundtable discussion on Demodex blepharitis, a prevalent ocular condition that often goes undiagnosed in patients.
View a roundtable discussion on...
09/04/2024
First Report Managed Care
Jordan Bazinsky
Videos
Addressing Health Disparities and Promoting Equity: The Role of Advanced Imaging Solutions
08/15/2024
Guest expert Jordan Bazinsky discusses the challenges facing the medical imaging industry, the potential of AI and emerging technologies, the role of advanced imaging solutions in promoting health equity, and the key trends and challenges...
Guest expert Jordan Bazinsky discusses the challenges facing the medical imaging industry, the potential of AI and emerging technologies, the role of advanced imaging solutions in promoting health equity, and the key trends and challenges...
Guest expert Jordan Bazinsky...
08/15/2024
First Report Managed Care
Farrukh Awan, MD
Videos
Promising Therapies and Clinical Trials for Chronic Lymphocytic Leukemia
08/14/2024
Farrukh Awan, MD, highlights promising therapies and clinical trials within the field of chronic lymphocytic leukemia (CLL).
Farrukh Awan, MD, highlights promising therapies and clinical trials within the field of chronic lymphocytic leukemia (CLL).
Farrukh Awan, MD, highlights...
08/14/2024
Journal of Clinical Pathways
Hayward
Videos
Evolving Health Care Contact Centers Into Drivers of Value-Based Care
07/31/2024
Discover how health care contact centers can transform into drivers of value-based care through AI, automation, upskilling agents, and rethinking workflows and metrics to improve patient outcomes and population health.
Discover how health care contact centers can transform into drivers of value-based care through AI, automation, upskilling agents, and rethinking workflows and metrics to improve patient outcomes and population health.
Discover how health care contact...
07/31/2024
First Report Managed Care
Lucille Accetta Headshot
Videos
Enhancing Patient Medication Adherence: Insights and Strategies From Asembia 2024
06/11/2024
Lucille Accetta, PharmD, MBA, MSPH, Senior Vice President of CVS Specialty Operations
Key stakeholders in the health care industry gathered to discuss prevalent topics at this year's Asembia annual summit. Medication adherence emerged as one of the most talked-about issues. In a session led by Lucille Accetta, PharmD, MBA,...
Key stakeholders in the health care industry gathered to discuss prevalent topics at this year's Asembia annual summit. Medication adherence emerged as one of the most talked-about issues. In a session led by Lucille Accetta, PharmD, MBA,...
Key stakeholders in the health...
06/11/2024
First Report Managed Care
Melissa Andel, Principal, CommonHealth Solutions, LLC
Videos
Navigating the Impact of the Inflation Reduction Act: Implications for Payers, Patients, and Manufacturers
05/24/2024
Melissa Andel, Principal, CommonHealth Solutions, LLC
Learn about the impacts of the Inflation Reduction Act on payers and patients, highlighting the changes in Medicare benefits and drug coverage coming in 2025 and 2026.
Learn about the impacts of the Inflation Reduction Act on payers and patients, highlighting the changes in Medicare benefits and drug coverage coming in 2025 and 2026.
Learn about the impacts of the...
05/24/2024
First Report Managed Care

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August 2020 Volume 17 Issue 7

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