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CMS to Expand Coverage for Ambulatory Blood Pressure Monitoring

08/26/2019

The Centers for Medicare & Medicaid Services announced a plan to expand coverage for ambulatory blood pressure monitoring (ABPM) in response to a request from stakeholders.

The Centers for Medicare &...

08/26/2019

First Report Managed Care

News Connection

Public Charge Rule Change Threatens Coverage for Millions of Children

08/26/2019

In October 2018, the Trump administration proposed rule changes to the criteria immigration officials use to determine whether an immigrant becomes a public charge and a recent study shows that these changes could result in over 8 million...

In October 2018, the Trump...

08/26/2019

First Report Managed Care

News Connection

Reduced Hep C Treatment Costs, Increased Manufacturer Revenue Under 340B

08/26/2019

According to a recent JAMA Network Open study, reduced list prices for hepatitis C treatments might have increased net revenue for drug manufacturers, due to lower discounts in the 340B program, as well as the higher share of sales using the...

According to a recent JAMA...

08/26/2019

First Report Managed Care

News Connection

MedPAC Urges Congress to Adopt Reforms to Improve Medicare Advantage

08/26/2019

The Medicare Payment Advisory Commission (MedPAC) recently submitted its 2019 annual report on Medicare payment policy to Congress with recommendations on billing reform in primary care, creating better access including eliminating “incident...

The Medicare Payment Advisory...

08/26/2019

First Report Managed Care

News Connection

AbbVie Set to Acquire Allergan in $63 Billion Deal

08/26/2019

In a time of mounting pressure from stakeholders to diversify its portfolio, AbbVie recently announced that the company has entered into a transaction agreement to acquire Allergan in a cash and stock deal worth approximately $63 billion.

In a time of mounting pressure...

08/26/2019

First Report Managed Care

News Connection

CMS Proposes Updates to Electronic Prescribing Standards

08/26/2019

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule aimed at providing patients better access to needed medications and reducing administrative burden by revising the prior authorization process for Medicare Part D.

The Centers for Medicare &...

08/26/2019

First Report Managed Care

News Connection

Uncontrolled Asthma Increases Economic Burden by Billions

08/26/2019

According to a recent study, despite numerous effective treatments for asthma, a significant faction of patients do not achieve sustained asthma control and could be faced with increased financial burden and decreased quality-adjusted life...

According to a recent study,...

08/26/2019

First Report Managed Care

News Connection

CMS Approves Rebate Negotiation, Subscription Model for Hep C Therapy

08/26/2019

The Centers for Medicare & Medicaid Services (CMS) announced that a state plan amendment (SPA) for supplemental rebate agreements utilizing subscription model for hepatitis C therapies in Medicaid has been approved in Lousiana.

The Centers for Medicare &...

08/26/2019

First Report Managed Care

News Connection

New CMS Guidance Issued to Enhance Medicaid Programs’ Integrity

08/26/2019

The Centers for Medicare & Medicaid Services (CMS) recently issued guidance for state Medicaid agencies in an effort to continue enhancing the financial and programmatic integrity of each program.

The Centers for Medicare &...

08/26/2019

First Report Managed Care

Conference Highlights

What to Expect at PCMH Congress 2019

08/21/2019

Christina Borden, director for recognition programs, policy, and resources at NCQA, provides an overview of what to expect at PCMH Congress 2019 including issues around social determinants of health and health disparity, and NCQA programs.

Christina Borden, director for...

08/21/2019

First Report Managed Care

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September 2024

Volume 21

Issue 3

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Anthem’s Outpatient Imaging Policy: the Economics of Restrictive Policies

12/20/2017

Jill Sederstorm ;

Anthem recently began rolling out a restrictive outpatient imaging policy, banning the services at hospitals when they are deemed clinically unnecessary.

Anthem recently began rolling...

12/20/2017

First Report Managed Care

News

Obama campaign promotes health care law

01/29/2012

First Report Managed Care

News

Health Insurer Anthem`s Profit Beats As Medicaid Enrollments Rise

04/29/2015

Anthem Inc (ANTM.N) has reported that their quarterly profit membership rise was greater than anticpated.

Anthem Inc (ANTM.N) has reported...

04/29/2015

First Report Managed Care

News

Determining the Most Cost-Effective Option to Treat Opioid Use Disorder

06/10/2019

A new study conducted by ICER sought to research the cost-effectiveness and value of utilizing an extended-release partial opioid agonist to treat patients with opioid-use disorder.

A new study conducted by ICER...

06/10/2019

First Report Managed Care

News

Backed by Pataki, conservative group launches campaign ad attacking supporters of healthcare reform

09/09/2010

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...

11/13/2024

First Report Managed Care

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...

10/31/2024

First Report Managed Care

Videos

Unmet Needs in the Treatment and Management of Non–Small Cell Lung Cancer

09/26/2024

Alexander Spira , MD, PhD;

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...

09/25/2024

First Report Managed Care

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...

09/04/2024

First Report Managed Care

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...

08/15/2024

First Report Managed Care

Videos

Promising Therapies and Clinical Trials for Chronic Lymphocytic Leukemia

08/14/2024

Farrukh T. Awan , MD;

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

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...

07/31/2024

First Report Managed Care

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...

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.

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