frmc Commentary

Commentary

The Impact of AI on Health Carrier Underwriting: Insights From Industry Experts

11/08/2024

"As AI continues to evolve, its integration into group health underwriting offers carriers new opportunities to enhance decision-making, streamline operations, and improve overall plan performance," said Jason Oswald, Director of Solution...

"As AI continues to evolve, its...

11/08/2024

First Report Managed Care

Commentary

Beyond Medical Cost Savings: Optimizing Payment Integrity Value

10/31/2024

Health plan leaders increasingly recognize the value of utilizing technology as a counteroffensive against high medical loss ratios, which are now close to 90% in the large group market. As the industry is poised to face the same pressures in...

Health plan leaders increasingly...

10/31/2024

First Report Managed Care

Commentary

Transforming Health Care Payer Operations With AI

10/11/2024

Milosz (Milo) Wicinski ;

Health plans today face mounting pressure to enhance member engagement while improving health outcomes and control rising costs. As health care inflation continues to outpace general inflation across the United States, health plans are...

Health plans today face mounting...

10/11/2024

First Report Managed Care

Commentary

How Capitation Contracts Can Benefit Provider and Payer Population Health Initiatives

10/04/2024

Lynn Carroll ;

In response to the vulnerabilities exposed by the COVID-19 pandemic, provider organizations are increasingly turning to capitation payment models to ensure revenue stability, improve care quality, and manage population health.

In response to the...

10/04/2024

First Report Managed Care

Commentary

Unlocking Value in Payment Integrity: A New Paradigm for Health Insurers

10/01/2024

From cost-cutting to value creation, learn how payment integrity is shifting towards a more holistic approach in the health care industry to enhance care quality and stakeholder relationships.

From cost-cutting to value...

10/01/2024

First Report Managed Care

Commentary

Navigating the CY 2025 CMS Physician Fee Schedule Proposals: Strategic Insights for Health Care Leaders

09/30/2024

Shannon Smith , RN, BSN;

The Centers for Medicare & Medicaid Services (CMS) has released its calendar year (CY) 2025 physician fee schedule proposals. In this commentary, an expert breaks down the key components and their implications for health care organizations.

The Centers for Medicare &...

09/30/2024

First Report Managed Care

Commentary

Providers Can Reduce Administrative Burden and Improve Productivity With AI Tools to Mitigate Labor Shortages

09/30/2024

Noel Felipe ;

As labor shortages continue to plague the health care industry, providers are turning to artificial intelligence tools to streamline administrative tasks, enhance patient care, and improve staff satisfaction, offering a glimpse into the...

As labor shortages continue to...

09/30/2024

First Report Managed Care

Commentary

Enhancing Provider Experience Through Electronic Prior Authorization

08/13/2024

Each year the American Medical Association (AMA) surveys its membership to ascertain their feedback concerning prior authorizations (PAs) and the impact of this service on their practice. Reliably, AMA members say that PAs are disruptive to...

Each year the American Medical...

08/13/2024

First Report Managed Care

Commentary

Payer-Provider Synergy: Aligning at the Fulcrum Points

08/05/2024

Payer-provider collaboration represents a crucial opportunity to bridge the gap between those who provide care and those who finance it. In this commentary, experts delve into strategies to help foster a collaborative relationship between...

Payer-provider collaboration...

08/05/2024

First Report Managed Care

Commentary

Easing the Nursing Shortage Burden With Wins on Quality, Cost, Scale

07/10/2024

Already challenged with cost, care, and administrative pressures, health care organizations are now staring down a daunting talent supply-and-demand gap. This shortage will negatively affect affordability and access to care for consumers and...

Already challenged with cost,...

07/10/2024

First Report Managed Care

Current Issue

September 2024

Volume 21

Issue 3

Current Issue

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News

New Approach Shows Promise for Treating Advanced Stage Ovarian Cancer in Lab

11/28/2014

A recombinant version of thrombospondin-1 type I repeats (3TSR) in combination with chemotherapy shows promise in a mouse model of advanced stage epithelial ovarian cancer.

A recombinant version of...

11/28/2014

First Report Managed Care

News

Cost of Autologous Stem Cell Transplant for Multiple Myeloma Decreasing

12/06/2017

Research presented at ASH 2017 will highlight how costs for autologous stem cell transplantation have decreased over the past decade.

Research presented at ASH 2017...

12/06/2017

First Report Managed Care

COPD Projected to be Third Leading Cause of Death by 2020

11/14/2014

Kerri Fitzgerald ;

Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide, and by 2020, COPD will be the third leading cause of mortality.

Chronic obstructive pulmonary...

11/14/2014

First Report Managed Care

News

Debt-limit deal triggers lobbying campaign from health-care and defense industries

08/04/2011

First Report Managed Care

News

Walgreens: no new Medicaid patients as of April 16

03/18/2010

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;

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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