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September 2017 - FRMC

Managed Care Q&A
Provider Groups Express Concerns With MACRA Transition
09/26/2017
David Costill
Jacqueline W Fincher, MD, Chairman of the Medical Practice & Quality Committee at ACP, recently explained how physcians and providers are adapting to the upcoming MACRA transition.
Jacqueline W Fincher, MD, Chairman of the Medical Practice & Quality Committee at ACP, recently explained how physcians and providers are adapting to the upcoming MACRA transition.
Jacqueline W Fincher, MD,...
09/26/2017
First Report Managed Care
Formulary Frontlines®
Breakthroughs in ALS Treatment
09/25/2017
Russell J. Spjut, PharmD
An outpouring of social awareness for amyotrophic lateral sclerosis research has led to the first new drug approved for treatment of the disease in 20 years.
An outpouring of social awareness for amyotrophic lateral sclerosis research has led to the first new drug approved for treatment of the disease in 20 years.
An outpouring of social...
09/25/2017
First Report Managed Care
Conference Insider
Not All Blood Glucose Monitors Effectively Help Manage Diabetes
09/25/2017
Despite FDA approval, many devices vary in their ability to accurately monitor blood glucose levels for diabetes patients, according to a session at the American Association of Diabetes Educators 2017 Annual Meeting.
Despite FDA approval, many devices vary in their ability to accurately monitor blood glucose levels for diabetes patients, according to a session at the American Association of Diabetes Educators 2017 Annual Meeting.
Despite FDA approval, many...
09/25/2017
First Report Managed Care
Conference Insider
Reducing the Burden of Type 2 Diabetes With Precision Medicine
09/25/2017
During the American Association of Diabetes Educators 2017 Annual Meeting, Erika Gebel Berg, PhD, discussed how precision medicine can be used to curb type 2 diabetes in patients with prediabetes symptoms.
During the American Association of Diabetes Educators 2017 Annual Meeting, Erika Gebel Berg, PhD, discussed how precision medicine can be used to curb type 2 diabetes in patients with prediabetes symptoms.
During the American Association...
09/25/2017
First Report Managed Care
Conference Insider
General Session: America’s Pipeline Conundrum: Paying for Cures
09/25/2017
On Tuesday, October 17, 2017, Alan Weil, JD, editor in chief of Health Affairs, will moderate the AMCP 2017 general session. Mr Weil is a leader in health care research, and frequently speaks on national health policy including Medicare and...
On Tuesday, October 17, 2017, Alan Weil, JD, editor in chief of Health Affairs, will moderate the AMCP 2017 general session. Mr Weil is a leader in health care research, and frequently speaks on national health policy including Medicare and...
On Tuesday, October 17, 2017,...
09/25/2017
First Report Managed Care
Conference Insider
Meeting Preview: AMCP Nexus 2017
09/25/2017
AMPC Nexus 2017, the Academy of Managed Care Pharmacy’s annual Meeting  (October 16–19 at the Gaylord Texan Resort & Convention Center in Dallas, Texas) is a literal nexus of professionals from all across the managed care spectrum coming...
AMPC Nexus 2017, the Academy of Managed Care Pharmacy’s annual Meeting  (October 16–19 at the Gaylord Texan Resort & Convention Center in Dallas, Texas) is a literal nexus of professionals from all across the managed care spectrum coming...
AMPC Nexus 2017, the Academy of...
09/25/2017
First Report Managed Care
News Connection
Anthem Axes Payments For Outpatient Imaging at Hospitals
09/25/2017
Anthem recently announced a new imaging payment policy, which excludes payments to hospitals for outpatient MRIs and CT scans.
Anthem recently announced a new imaging payment policy, which excludes payments to hospitals for outpatient MRIs and CT scans.
Anthem recently announced a new...
09/25/2017
First Report Managed Care
News Connection
Bipartisan Group of Governors Release ACA Health Reform Plan
09/25/2017
A group of eight United States governors released a comprehensive plan for stabilizing the ACA through congressional reform in an open letter to the Majority and Minority leaders of both congressional houses. 
A group of eight United States governors released a comprehensive plan for stabilizing the ACA through congressional reform in an open letter to the Majority and Minority leaders of both congressional houses. 
A group of eight United States...
09/25/2017
First Report Managed Care
News Connection
Consolidated Provider Networks, Hospital Systems Reduce Payer Costs
09/25/2017
A recent study in Health Affairs found that provider networks and hospital systems that concentrated providers resulted in payers having more power to negotiate lower health service costs.
A recent study in Health Affairs found that provider networks and hospital systems that concentrated providers resulted in payers having more power to negotiate lower health service costs.
A recent study in Health Affairs...
09/25/2017
First Report Managed Care
Oncology Care Model: Delivering Better Care
09/15/2017
Jill Sederstorm
The CMS Oncology Care Model turned 1 year old this July.
The CMS Oncology Care Model turned 1 year old this July.
The CMS Oncology Care Model...
09/15/2017
First Report Managed Care
The Cost Burden of a Cure: Treating HCV
09/15/2017
Mary Beth Nierengarten
Curative HCV Treatments have been a godsend for patients suffering from the debilitating infections disease—however, high costs still remain an issue for payers.
Curative HCV Treatments have been a godsend for patients suffering from the debilitating infections disease—however, high costs still remain an issue for payers.
Curative HCV Treatments have...
09/15/2017
First Report Managed Care
Why Returning to a Pre-ACA Market Isn’t an Option
09/12/2017
Dean Celia
In July, HHS Secretary Tom Price wondered why payers cannot or will not “dust off how they did business before Obamacare” if given the opportunity.
In July, HHS Secretary Tom Price wondered why payers cannot or will not “dust off how they did business before Obamacare” if given the opportunity.
In July, HHS Secretary Tom Price...
09/12/2017
First Report Managed Care
Transgender Patients: Calculating the Actual Cost
09/11/2017
Dave Muoio
An unexpected announcement from President Donald Trump has propelled discussions on the costs and complications of transgender medical care into the mainstream.
An unexpected announcement from President Donald Trump has propelled discussions on the costs and complications of transgender medical care into the mainstream.
An unexpected announcement from...
09/11/2017
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
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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

September 2017 Volume 14 Issue 9

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