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Integrated CKD Care Models Could Improve Early Detection and Outcomes
06/15/2026
Hannah Musick
Population health management strategies that combine early chronic kidney disease (CKD) detection, risk stratification, and integrated primary-nephrology care may help reduce disease progression, cardiovascular complications, and health care...
Population health management strategies that combine early chronic kidney disease (CKD) detection, risk stratification, and integrated primary-nephrology care may help reduce disease progression, cardiovascular complications, and health care...
Population health management...
06/15/2026
First Report Managed Care
Behind the Bill
CMS Tightens Oversight of Medicaid Demonstration Programs and State-Directed Payments
06/12/2026
Grace Taylor, MS, MA
As the Centers for Medicare & Medicaid Services (CMS) intensifies its review of Medicaid demonstration waivers and state-directed payments, managed care stakeholders are assessing what heightened federal scrutiny could mean for program...
As the Centers for Medicare & Medicaid Services (CMS) intensifies its review of Medicaid demonstration waivers and state-directed payments, managed care stakeholders are assessing what heightened federal scrutiny could mean for program...
As the Centers for Medicare &...
06/12/2026
First Report Managed Care
News
Datopotamab Deruxtecan Combinations Show Durable Activity in Advanced NSCLC
06/11/2026
Hannah Musick
Datopotamab deruxtecan plus pembrolizumab, with or without platinum-based chemotherapy, produced durable responses and manageable safety across programmed death-ligand 1 expression levels in patients with advanced non–small cell lung cancer...
Datopotamab deruxtecan plus pembrolizumab, with or without platinum-based chemotherapy, produced durable responses and manageable safety across programmed death-ligand 1 expression levels in patients with advanced non–small cell lung cancer...
Datopotamab deruxtecan plus...
06/11/2026
First Report Managed Care
News
Disparities in OB/GYN-Ordered CRC Screenings Based on Age, Race, and Income
06/09/2026
Rebecca Amrick
Obstetrician/gynecologist (OB/GYN) offices may serve as an additional setting to inform women on colorectal cancer (CRC) and provide preventative screenings, but discrepancies in care still exist based on age, race, income, and insurance...
Obstetrician/gynecologist (OB/GYN) offices may serve as an additional setting to inform women on colorectal cancer (CRC) and provide preventative screenings, but discrepancies in care still exist based on age, race, income, and insurance...
Obstetrician/gynecologist...
06/09/2026
First Report Managed Care
News
Pneumonia Hospitalizations Drive Rising Costs in Multiple Myeloma Care
06/08/2026
Grace Taylor, MS, MA
Pneumonia-related hospitalizations among patients with multiple myeloma are becoming increasingly costly despite declining mortality rates, highlighting persistent disparities and the urgent need for strategies to prevent serious infections...
Pneumonia-related hospitalizations among patients with multiple myeloma are becoming increasingly costly despite declining mortality rates, highlighting persistent disparities and the urgent need for strategies to prevent serious infections...
Pneumonia-related...
06/08/2026
First Report Managed Care
News
Food-Restricted TKIs Associated With Adherence Challenges in CML
06/08/2026
Grace Taylor, MS, MA
A US survey of patients with chronic myeloid leukemia (CML) found that food restrictions associated with certain tyrosine kinase inhibitors (TKIs) may complicate daily routines, reduce treatment adherence, and increase interest in more...
A US survey of patients with chronic myeloid leukemia (CML) found that food restrictions associated with certain tyrosine kinase inhibitors (TKIs) may complicate daily routines, reduce treatment adherence, and increase interest in more...
A US survey of patients with...
06/08/2026
First Report Managed Care
News
Pharmacist-Led Outreach Boosts SGLT2 Inhibitor Initiation in Veterans With CKD and Diabetes
06/05/2026
Grace Taylor, MS, MA
Clinical pharmacists nearly doubled SGLT2 inhibitor initiation among veterans with chronic kidney disease (CKD) and type 2 diabetes in a large US Department of Veterans Affairs quality improvement study.
Clinical pharmacists nearly doubled SGLT2 inhibitor initiation among veterans with chronic kidney disease (CKD) and type 2 diabetes in a large US Department of Veterans Affairs quality improvement study.
Clinical pharmacists nearly...
06/05/2026
First Report Managed Care
News
Reducing Reliance on Epidural Steroid Injections Through Evidence-Based De-Implementation
06/05/2026
Rebecca Amrick
Researchers examined epidural spinal injections as a candidate for de-implementation, specifically for patients with chronic low back pain, and provided suggestions for successfully redirecting care toward more effective and sustainable...
Researchers examined epidural spinal injections as a candidate for de-implementation, specifically for patients with chronic low back pain, and provided suggestions for successfully redirecting care toward more effective and sustainable...
Researchers examined epidural...
06/05/2026
First Report Managed Care
News
CT-P39 Shows Promise as a Cost-Saving Alternative to Omalizumab for CSU
06/04/2026
Rebecca Amrick
A clinical trial comparing CT-P39 with reference omalizumab found both drugs to be comparable both in efficacy and safety, indicating CT-P39 as a suitable alternative to omalizumab for patients with chronic spontaneous urticaria (CSU).
A clinical trial comparing CT-P39 with reference omalizumab found both drugs to be comparable both in efficacy and safety, indicating CT-P39 as a suitable alternative to omalizumab for patients with chronic spontaneous urticaria (CSU).
A clinical trial comparing...
06/04/2026
First Report Managed Care
Behind the Bill
CMS Finalizes Federal IDR Rule to Streamline No Surprises Act Dispute Resolution
05/29/2026
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) has finalized updates to the federal Independent Dispute Resolution (IDR) process under the No Surprises Act, lowering administrative fees, creating a centralized dispute portal, and...
The Centers for Medicare & Medicaid Services (CMS) has finalized updates to the federal Independent Dispute Resolution (IDR) process under the No Surprises Act, lowering administrative fees, creating a centralized dispute portal, and...
The Centers for Medicare &...
05/29/2026
First Report Managed Care

Pipeline Projections

PIPELINE PROJECTIONS
Emerging Therapies Reshaping Atopic Dermatitis Care
03/26/2026
Roy Moore
Roy Moore outlines how a rapidly expanding atopic dermatitis pipeline is intensifying competition, reshaping payer strategies, and raising the bar for new therapies.
Roy Moore outlines how a rapidly expanding atopic dermatitis pipeline is intensifying competition, reshaping payer strategies, and raising the bar for new therapies.
Roy Moore outlines how a rapidly...
03/26/2026
First Report Managed Care
Pipe
Pipeline Projections
Emerging Migraine Treatments Challenge a Mature Market
11/20/2025
Roy Moore
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market...
11/20/2025
First Report Managed Care
Pipeline Projections
Pipeline Projections
Redefining Asthma Management With Emerging Anti-Inflammatories
10/01/2025
Roy Moore
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access...
10/01/2025
First Report Managed Care
Pipeline Projections
The Shift in MS Care as Biologics and BTK Inhibitors Advance
07/25/2025
Roy Moore
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline...
07/25/2025
First Report Managed Care
Pipeline Projections
How Biosimilars Are Shaping RA Treatment and Reimbursement Strategies
04/29/2025
Roy Moore
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline...
04/29/2025
First Report Managed Care

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Behind the Bill

Behind the Bill
HHS Hits Reset on 340B Rebate Model After Court Setbacks
02/11/2026
Juliet Gallagher
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and...
02/11/2026
First Report Managed Care
Behind the Bill
Funding Package Extends Medicare Telehealth, Enacts PBM Reforms, and Updates Hospital Oversight
02/05/2026
Juliet Gallagher
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President...
02/05/2026
First Report Managed Care
Behind the Bill
The Senate’s $3 Trillion Deal. Tax Relief Now, Medicaid Coverage Loss Later?
07/02/2025
Katie Hayes, MJ
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After...
07/02/2025
First Report Managed Care
Behind the Bill
When a Cap Isn’t Just a Cap: How a Provider Tax Proposal Could Reshape Medicaid Financing
06/25/2025
Katie Hayes, MJ
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most...
06/25/2025
First Report Managed Care
Behind the Bill
Rewriting the Safety Net? Inside the Senate’s Changes to Medicaid and the ACA
06/18/2025
Katie Hayes, MJ
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve...
06/18/2025
First Report Managed Care
Behind the Bill
How States Might Respond to the One Big Beautiful Bill Act
06/11/2025
Katie Hayes, MJ
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill...
06/11/2025
First Report Managed Care
Behind the Bill
Is the Affordable Care Act on the Chopping Block? What the One Big Beautiful Bill Act Tells Us.
06/04/2025
Katie Hayes, MJ
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of...
06/04/2025
First Report Managed Care
Behind the Bill
From House to Senate: The Journey of Cutting Medicaid
05/28/2025
Katie Hayes, MJ
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of...
05/28/2025
First Report Managed Care
Behind the Bill
Eligibility, Paperwork, and Penalties: The Not-So-Hidden Costs of Medicaid ‘Reform’
05/21/2025
Katie Hayes, MJ
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week...
05/21/2025
First Report Managed Care
Behind the Bill
A Busy Week in Drug Pricing Policy: Aligning US Drug Prices With Global Standards?
05/14/2025
Katie Hayes, MJ
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for...
05/14/2025
First Report Managed Care

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