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June 2016 - FRMC

Playing Games: Adopting Game-Based Strategies Can Improve Engagement and Outcomes
07/12/2016
Jill Sederstorm
Games aren't just for fun anymore—research has shown that incorporating game-based strategies into patient outreach or physician training and education cannot only improve engagement, it can also lead to better outcomes. "I see games and...
Games aren't just for fun anymore—research has shown that incorporating game-based strategies into patient outreach or physician training and education cannot only improve engagement, it can also lead to better outcomes. "I see games and...
Games aren't just for fun...
07/12/2016
First Report Managed Care
Department
Treatment Recommendations and Managed Care Considerations for Patients With Rheumatoid Arthritis
07/12/2016
For patients with rheumatoid arthritis who continue to have moderate to severe disease activity despite treatment with conventional disease modifying antirheumatic drugs, tumor necrosis factor inhibitors have long been a mainstay in treatment...
For patients with rheumatoid arthritis who continue to have moderate to severe disease activity despite treatment with conventional disease modifying antirheumatic drugs, tumor necrosis factor inhibitors have long been a mainstay in treatment...
For patients with rheumatoid...
07/12/2016
First Report Managed Care
Department
Pharmacoeconomics: Weighing the Benefits to the Costs
07/12/2016
The use of a cost-effectiveness analysis in medical decision-making is increasing as health care delivery moves from volume-based reimbursement models to value-based models.
The use of a cost-effectiveness analysis in medical decision-making is increasing as health care delivery moves from volume-based reimbursement models to value-based models.
The use of a cost-effectiveness...
07/12/2016
First Report Managed Care
Department
Opening the Door to a Payment Paradigm Shift
07/12/2016
With specialty drugs expected to account for half of total drug spending by 2018, payers are beginning to target the pricey medications for utilization management.
With specialty drugs expected to account for half of total drug spending by 2018, payers are beginning to target the pricey medications for utilization management.
With specialty drugs expected to...
07/12/2016
First Report Managed Care
Department
Improving Value Through Pharmacist/Physician Collaboration
07/11/2016
Clinical pharmacists can help free up physician time by providing disease management support and providing education on disease states and medications.
Clinical pharmacists can help free up physician time by providing disease management support and providing education on disease states and medications.
Clinical pharmacists can...
07/11/2016
First Report Managed Care
Department
Cost Management Approaches for Expensive Drugs
07/11/2016
Addressing rising pharmaceutical costs is a top challenge for today’s managed care executives.
Addressing rising pharmaceutical costs is a top challenge for today’s managed care executives.
Addressing rising pharmaceutical...
07/11/2016
First Report Managed Care
Department
IMS Health Expert Discusses State of Pharmaceutical Industry
07/11/2016
The US pharmaceutical market saw double-digit growth in terms of prescription drug spend in 2015.
The US pharmaceutical market saw double-digit growth in terms of prescription drug spend in 2015.
The US pharmaceutical market saw...
07/11/2016
First Report Managed Care
Department
Tug-of-War: Driving Fair Drug Prices
07/11/2016
Record-high drug prices, which are out of reach for many patients and unsustainable for payers, threaten to break the health care system.
Record-high drug prices, which are out of reach for many patients and unsustainable for payers, threaten to break the health care system.
Record-high drug prices, which...
07/11/2016
First Report Managed Care
Formulary Frontlines®
The Progression of Parkinson`s Disease
07/11/2016
This chronic and progressive disorder, marked by increasing worsening of symptoms, is second only to Alzheimer’s as the most prevalent neurodegenerative disease Parkinson’s disease occurs when neurons in the brain die or become impaired,...
This chronic and progressive disorder, marked by increasing worsening of symptoms, is second only to Alzheimer’s as the most prevalent neurodegenerative disease Parkinson’s disease occurs when neurons in the brain die or become impaired,...
This chronic and progressive...
07/11/2016
First Report Managed Care
Department
June 2016: Top FDA Approvals
07/11/2016
The top FDA approvals for June 2016 include Type 2 Diabetes treatment, a 4-strain influenza vaccine, urothelial carcinoma treatment, and more. 
The top FDA approvals for June 2016 include Type 2 Diabetes treatment, a 4-strain influenza vaccine, urothelial carcinoma treatment, and more. 
The top FDA approvals for June...
07/11/2016
First Report Managed Care
News Connection
MACRA Town Hall: Effects on Your Medicare Reimbursement
07/11/2016
At the “MACRA Town Hall: Effects on Your Medicare Reimbursement” session held as part of the American Society of Clinical Oncology Annual Meeting, Blaise Polite, MD, MPP, University of Chicago, Illinois, described MACRA using 3 key...
At the “MACRA Town Hall: Effects on Your Medicare Reimbursement” session held as part of the American Society of Clinical Oncology Annual Meeting, Blaise Polite, MD, MPP, University of Chicago, Illinois, described MACRA using 3 key...
At the “MACRA Town Hall: Effects...
07/11/2016
First Report Managed Care
News Connection
New Playbook Guides Hospitals on Problem of Drug-Resistant Bacteria
07/11/2016
The National Quality Forum recently published the Antibiotic Stewardship in Acute Care: A Practical Playbook to guide hospitals in significantly reducing antibiotic misuse and overuse.
The National Quality Forum recently published the Antibiotic Stewardship in Acute Care: A Practical Playbook to guide hospitals in significantly reducing antibiotic misuse and overuse.
The National Quality...
07/11/2016
First Report Managed Care
News Connection
More Lives Saved With Risk-Based Lung Cancer Screening
07/11/2016
An alternative approach to lung cancer screening could better detect risk than current US Preventive Services Task Force screening guidelines, suggests a new study. 
An alternative approach to lung cancer screening could better detect risk than current US Preventive Services Task Force screening guidelines, suggests a new study. 
An alternative approach to lung...
07/11/2016
First Report Managed Care
News Connection
Study: Gout Drug Cardioprotective in Older Adults
07/11/2016
Findings of a new study suggest that long-term use of allopurinol is associated with reduced risk of incident atrial fibrillation in older adults.
Findings of a new study suggest that long-term use of allopurinol is associated with reduced risk of incident atrial fibrillation in older adults.
Findings of a new study suggest...
07/11/2016
First Report Managed Care
News Connection
Lower Dose of Stroke Drug Reduces Risk of Hemorrhage
07/11/2016
A lower-than-standard dose of intravenous alteplase (Activase; Genentech) for the treatment of patients with acute ischemic stroke is noninferior to the standard dose and is associated with significantly reduced risk of intracerebral...
A lower-than-standard dose of intravenous alteplase (Activase; Genentech) for the treatment of patients with acute ischemic stroke is noninferior to the standard dose and is associated with significantly reduced risk of intracerebral...
A lower-than-standard dose of...
07/11/2016
First Report Managed Care
News Connection
Job Supports and Job Retention Among Working Patients With Colorectal Cancer
07/11/2016
A session at the American Society of Clinical Oncology Annual Meeting examined how job supports affected job retention among patients with colorectal cancer. 
A session at the American Society of Clinical Oncology Annual Meeting examined how job supports affected job retention among patients with colorectal cancer. 
A session at the American...
07/11/2016
First Report Managed Care
Payers, Providers Need to Deliver Consumer-Friendly Value-Based Care
06/30/2016
Dean Celia
Patients want value from their health care interactions, but they also want their experience to be personalized. 
Patients want value from their health care interactions, but they also want their experience to be personalized. 
Patients want value from their...
06/30/2016
First Report Managed Care
News
NCQA: Early Intervention, Quality Follow-Up Care to Combat High Cost of Mental Health Care
06/30/2016
Paul Nicolaus
A new study conducted by the National Committee for Quality Assurance hopes to aid in the development of measures intended to improve the quality of depression care. 
A new study conducted by the National Committee for Quality Assurance hopes to aid in the development of measures intended to improve the quality of depression care. 
A new study conducted by the...
06/30/2016
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

June 2016 Volume 13 Issue 6

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