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Commentary

Julie Schulz headshot
Commentary
How Lab Values Can Close the Gap Between Patients With Undiagnosed and Under-Staged Chronic Kidney Disease
03/27/2024

By Julie Schulz, MD, MPH

By Julie Schulz, MD, MPH
Chronic kidney disease (CKD) is an insidious condition with devastating consequences when detected and treated too late. While primary care physicians usually make the initial diagnosis, regular screening is not routine for the general...
Chronic kidney disease (CKD) is an insidious condition with devastating consequences when detected and treated too late. While primary care physicians usually make the initial diagnosis, regular screening is not routine for the general...
Chronic kidney disease (CKD) is...
03/27/2024
First Report Managed Care
Kevin/Avikar Hedshots
Commentary
From Data to Decision: How Generative AI is Shaping Patient Care Pathways
03/20/2024

Kevin Riley, CEO, President, Zyter|TruCare; Avikar Govil, Insights Health Product Manager, Zyter|TruCare

Kevin Riley, CEO, President, Zyter|Tr...
The rapid evolution of Generative Artificial Intelligence (Gen AI) is fundamentally transforming the health care industry, ushering in an era of increased personalization, efficiency, and improved patient outcomes. In this commentary, experts...
The rapid evolution of Generative Artificial Intelligence (Gen AI) is fundamentally transforming the health care industry, ushering in an era of increased personalization, efficiency, and improved patient outcomes. In this commentary, experts...
The rapid evolution of...
03/20/2024
First Report Managed Care

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James Wallace Headshot
Commentary
The Key to Improving Medication Adherence: The “Right” Medication for Each Patient
03/08/2024

James Wallace, CEO of DecisionRx

James Wallace, CEO of DecisionRx ...
Medication adherence poses a significant challenge in health care, with far-reaching consequences for patients and the health care system. It is a complex issue influenced by various factors, including undesirable side effects, lack of...
Medication adherence poses a significant challenge in health care, with far-reaching consequences for patients and the health care system. It is a complex issue influenced by various factors, including undesirable side effects, lack of...
Medication adherence poses a...
03/08/2024
First Report Managed Care
Commentary
Next-Generation Utilization Management: Managing Utilization and Cost Without Denial of Service​​​
03/01/2024

Amit Gupta, MD, Medical Director, Clinical Strategy at Sagility

Amit Gupta, MD, Medical Director, Cli...
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is...
03/01/2024
First Report Managed Care
Commentary
Unlocking Health Care Efficiency: CMS Overhauls Prior Authorization in Landmark Interoperability Rule—What Payers Need to Know Now
03/01/2024

Michael Gould, AVP, Interoperability Strategy at ZeOmega

Michael Gould, AVP, Interoperability ...
CMS has published the Interoperability and Prior Authorization final rule to drive transformative outcomes in the health care ecosystem, requiring payers and providers to adopt new standards and FHIR APIs to reduce inefficiencies and improve...
CMS has published the Interoperability and Prior Authorization final rule to drive transformative outcomes in the health care ecosystem, requiring payers and providers to adopt new standards and FHIR APIs to reduce inefficiencies and improve...
CMS has published the...
03/01/2024
First Report Managed Care

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Alex Sommer
Commentary
What Insurance Plans Need to Know About Biomarker Legislation
02/14/2024

Alex Sommer, vice president, State Government Affairs, Avalon Healthcare Solutions

Alex Sommer, vice president, State Go...
Biomarker bills are merely the latest in what is likely to be a wave of legislation mandating coverage of new tests and therapies that are part of the growth in precision medicine. This will make it increasingly difficult for plans to control...
Biomarker bills are merely the latest in what is likely to be a wave of legislation mandating coverage of new tests and therapies that are part of the growth in precision medicine. This will make it increasingly difficult for plans to control...
Biomarker bills are merely the...
02/14/2024
First Report Managed Care
Christie Headshot
Commentary
How Medicare Advantage Plans Can Prepare for the CMS Health Equity Index
02/13/2024

Christie Teigland, PhD, VP of Research Science and Advanced Analytics, Inovalon

Christie Teigland, PhD, VP of Researc...
As part of the 2024 Medicare Advantage (MA) and Part D Final Rule, CMS is enhancing the Star Ratings program by implementing a Health Equity Index (HEI) reward to incentivize MA and Part D contracts with 500 or more members to address...
As part of the 2024 Medicare Advantage (MA) and Part D Final Rule, CMS is enhancing the Star Ratings program by implementing a Health Equity Index (HEI) reward to incentivize MA and Part D contracts with 500 or more members to address...
As part of the 2024 Medicare...
02/13/2024
First Report Managed Care
Commentary
Request for FDA Approval: Prescription Digital Therapeutic Targeting Liver Disease With Breakthrough Device Designation
01/24/2024

Lisa Kuhns, PhD

Lisa Kuhns, PhD
In January 2024, Better Therapeutics, Inc submitted a request to the US Food and Drug Administration (FDA) for Breakthrough Device Designation for its new prescription digital therapeutic (PDT) designed to treat metabolic...
In January 2024, Better Therapeutics, Inc submitted a request to the US Food and Drug Administration (FDA) for Breakthrough Device Designation for its new prescription digital therapeutic (PDT) designed to treat metabolic...
In January 2024, Better...
01/24/2024
First Report Managed Care

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KOL Headshots
Commentary
2024 Predictions: Key Trends Identified by Business Leaders and Health Care Experts in Value-Based Care
01/23/2024
In this exclusive commentary for First Report Managed Care, health experts and business leaders share insights into predictions for the 2024 value-based care landscape. Insights highlight trends in behavioral health, AI integration,...
In this exclusive commentary for First Report Managed Care, health experts and business leaders share insights into predictions for the 2024 value-based care landscape. Insights highlight trends in behavioral health, AI integration,...
In this exclusive commentary for...
01/23/2024
First Report Managed Care
Commentary
New Partnership Integrates AspyreRx Digital Treatment for Type 2 Diabetes
01/12/2024

Lisa Kuhns, PhD

Lisa Kuhns, PhD
In January 2024, Better Therapeutics Inc. and Glooko Inc. announced a partnership to integrate Better Therapeutics’ AspyreRx™ digital behavioral treatment for type 2 diabetes (T2D) into Glooko’s diabetes management platform.
In January 2024, Better Therapeutics Inc. and Glooko Inc. announced a partnership to integrate Better Therapeutics’ AspyreRx™ digital behavioral treatment for type 2 diabetes (T2D) into Glooko’s diabetes management platform.
In January 2024, Better...
01/12/2024
First Report Managed Care

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FRMC Volume 21, Issue 3

Current Issue

September 2024
Volume 21
Issue 3
Current Issue
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News
Identifying Large-Vessel Vasculitis in Polymyalgia Rheumatica: Key Clinical and Laboratory Red Flags
04/05/2024
Lisa Kuhns, PhD
Potential red flags for large-vessel vasculitis in isolated polymyalgia rheumatica (PMR) include inflammatory back pain, significant pelvic involvement, widespread lower extremity pain, marked inflammatory response indicated by specific lab...
Potential red flags for large-vessel vasculitis in isolated polymyalgia rheumatica (PMR) include inflammatory back pain, significant pelvic involvement, widespread lower extremity pain, marked inflammatory response indicated by specific lab...
Potential red flags for...
04/05/2024
First Report Managed Care
News
HHS Unveils Comprehensive Healthcare Reforms to Boost Equity and Quality
09/13/2024
The US Department of Health and Human Services (HHS) has announced updates to Medicare payments and policies to improve healthcare accessibility, equity, and quality for millions of Americans, according to a press release by the HHS.
The US Department of Health and Human Services (HHS) has announced updates to Medicare payments and policies to improve healthcare accessibility, equity, and quality for millions of Americans, according to a press release by the HHS.
The US Department of Health and...
09/13/2024
First Report Managed Care
Examining Videos on YouTube for Hypertension
09/22/2014

Tim Casey

Tim Casey
New York—An analysis of popular search terms on YouTube found that approximately two-thirds of the videos related to hypertension were useful to people; however, those videos were the least likely to be viewed. Researchers presented the...
New York—An analysis of popular search terms on YouTube found that approximately two-thirds of the videos related to hypertension were useful to people; however, those videos were the least likely to be viewed. Researchers presented the...
New York—An analysis of popular...
09/22/2014
First Report Managed Care
Conference Coverage
SOHO 2024 Insights: Examining the Use and Cost of Interferon Therapy for MPNs
09/13/2024
In this interview, a leading expert discusses myeloproliferative neoplasms, as presented at the SOHO annual conference. Explore the interview to gain key insights into interferon therapies and important considerations for payers regarding...
In this interview, a leading expert discusses myeloproliferative neoplasms, as presented at the SOHO annual conference. Explore the interview to gain key insights into interferon therapies and important considerations for payers regarding...
In this interview, a leading...
09/13/2024
First Report Managed Care
News
Choice of Health Plans to Vary Sharply From State to State
06/17/2013
06/17/2013
First Report Managed Care

Video Insights

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
Joe DePinto Headshot
Videos
Navigating Payment Models in the CGT Landscape: Insights and Innovations
05/21/2024
Joe DePinto, Head of Cell, Gene, and Advanced Therapies, McKesson
An expert discusses the evolution and challenges of payment models in the cell and gene therapy (CGT) space reviewed during his session at Asembia 2024.
An expert discusses the evolution and challenges of payment models in the cell and gene therapy (CGT) space reviewed during his session at Asembia 2024.
An expert discusses the...
05/21/2024
First Report Managed Care
Jennifer L. Mathieu Senior Vice President, Professional and Government Affairs at AMCP
Videos
Unlocking the Future of Managed Care Pharmacy: A Deep Dive into Federal Legislation and Regulations
05/15/2024
Jennifer L. Mathieu Senior Vice President, Professional and Government Affairs, AMCP
Learn about developments in federal legislation and regulations within the pharmacy landscape shaping the future of managed care in an interview with a session presenter from AMCP 2024.
Learn about developments in federal legislation and regulations within the pharmacy landscape shaping the future of managed care in an interview with a session presenter from AMCP 2024.
Learn about developments in...
05/15/2024
First Report Managed Care
Peter Martin, MD
Conference Coverage
Using Lenalidomide and Rituximab, Tazemetostat, or Bispecific Antibodies to Treat Patients With Follicular Lymphoma
04/06/2024

Featuring Peter Martin, MD

Featuring Peter Martin, MD
During the 2024 Great Debates & Updates in Hematologic Malignancies meeting in New York, Peter Martin, MD, argued in favor of alternative treatment regimens over CAR T-cell therapy for treating follicular lymphoma.
During the 2024 Great Debates & Updates in Hematologic Malignancies meeting in New York, Peter Martin, MD, argued in favor of alternative treatment regimens over CAR T-cell therapy for treating follicular lymphoma.
During the 2024 Great Debates &...
04/06/2024
Oncology
Tejaswi Kompala
Videos
Personalizing Weight Loss Management With GLP-1 Agonists
04/05/2024

Featuring Tejaswi Kompala, MD, head of cardiometabolic clinical strategy, Teladoc 

Featuring Tejaswi Kompala, MD, head o...
Delve into the rising demand for anti-obesity medications, the complexities of obesity management, and the importance of personalized approaches in improving cardiometabolic health in this insightful interview.
Delve into the rising demand for anti-obesity medications, the complexities of obesity management, and the importance of personalized approaches in improving cardiometabolic health in this insightful interview.
Delve into the rising demand for...
04/05/2024
First Report Managed Care

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