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Interview
Smarter Prior Authorization: Using AI to Improve Care Access and Cut Costs
08/11/2025
Brian Covino, MD; Siva Namasivayam
In this interview, Brian Covino, MD, and Siva Namasivayam of Cohere Health discuss how AI is revolutionizing the prior authorization process by dramatically improving speed, reducing administrative burden, and enhancing care accuracy—while...
In this interview, Brian Covino, MD, and Siva Namasivayam of Cohere Health discuss how AI is revolutionizing the prior authorization process by dramatically improving speed, reducing administrative burden, and enhancing care accuracy—while...
In this interview, Brian Covino,...
08/11/2025
First Report Managed Care
Varshney Headshot
Interview
Transforming Drug Development Through Real-World Evidence and Artificial Intelligence
01/03/2025
Jo Varshney, DVM, PhD
In this interview, Dr Jo Varshney, founder and CEO of VeriSIM Life, discusses the complexities of drug development, the role of AI in accelerating discovery, the integration of real-world evidence, and strategies to reduce costs while...
In this interview, Dr Jo Varshney, founder and CEO of VeriSIM Life, discusses the complexities of drug development, the role of AI in accelerating discovery, the integration of real-world evidence, and strategies to reduce costs while...
In this interview, Dr Jo...
01/03/2025
First Report Managed Care
Josh Reischer
Interview
Integrating AI Advancements Into Clinical Care
08/15/2024
Josh Reischer, MD
Josh Reischer, MD, CEO and Co-Founder of Health Note, answers our burning questions about integrating artificial intelligence and other technology tools into health care.
Josh Reischer, MD, CEO and Co-Founder of Health Note, answers our burning questions about integrating artificial intelligence and other technology tools into health care.
Josh Reischer, MD, CEO and...
08/15/2024
First Report Managed Care
Venkatgiri Vandali
Interview
Maximizing Efficiency and Patient Care With Generative AI
08/12/2024
Venkatgiri Vandali
The role of generative AI in managing data is explored and the potential impact of payers, providers, and patients in this interview with industry expert Venkatgiri Vandali of Firstsource.
The role of generative AI in managing data is explored and the potential impact of payers, providers, and patients in this interview with industry expert Venkatgiri Vandali of Firstsource.
The role of generative AI in...
08/12/2024
First Report Managed Care
Katie Devlin
Interview
Strategies for Adjusting With Health Care Interoperability
07/01/2024
Katie Devlin, DHSc, MS, CPHIMS
In this interview, Katie Devlin, VP of Interoperability at Cotiviti, discusses the impact of major shifts like TEFCA and the CMS Interoperability Rule on health plans, emphasizing the importance of joining a QHIN to increase data...
In this interview, Katie Devlin, VP of Interoperability at Cotiviti, discusses the impact of major shifts like TEFCA and the CMS Interoperability Rule on health plans, emphasizing the importance of joining a QHIN to increase data...
In this interview, Katie Devlin,...
07/01/2024
First Report Managed Care
Joe Honcz
Interview
Exploring Future Possibilities of AI in Managed Care Pharmacy Practice
05/20/2024
Guest expert and AMCP 2024 session presenter Joseph Honcz, RPh, MBA, explores the current role of AI in managed care, barriers to implementation, and strategies for collaborating with managed care leadership to advance the testing of AI...
Guest expert and AMCP 2024 session presenter Joseph Honcz, RPh, MBA, explores the current role of AI in managed care, barriers to implementation, and strategies for collaborating with managed care leadership to advance the testing of AI...
Guest expert and AMCP 2024...
05/20/2024
First Report Managed Care
Jay Ackerman Headshot
Interview
AI's Impact on Value-Based Care Outcomes
05/07/2024
Artificial intelligence (AI)-powered workflows and prospective analytics are advancing value-based care by improving patient outcomes and reducing costs. In a recent interview, an expert emphasizes that leveraging AI technologies enables...
Artificial intelligence (AI)-powered workflows and prospective analytics are advancing value-based care by improving patient outcomes and reducing costs. In a recent interview, an expert emphasizes that leveraging AI technologies enables...
Artificial intelligence...
05/07/2024
First Report Managed Care
Steve Vacarro
Interview
The Role of Electronic Visit Verification in Enhancing Quality, Efficiency, and Medicaid Integrity
02/29/2024

Featuring Stephen Vaccaro, president, HHAeXchange

Featuring Stephen Vaccaro, president,...
In this interview, an expert discusses the importance of Electronic Visit Verification (EVV) in homecare services. EVV ensures accurate documentation of homecare visits, leading to improved patient outcomes and quality of care. Medicaid has a...
In this interview, an expert discusses the importance of Electronic Visit Verification (EVV) in homecare services. EVV ensures accurate documentation of homecare visits, leading to improved patient outcomes and quality of care. Medicaid has a...
In this interview, an expert...
02/29/2024
First Report Managed Care
Cindy Gaines Headshot
Interview
Exploring Automation for Hospital-at-Home Care Coordination
01/19/2024
Cindy Gaines, MSN, RN
The health care industry increasingly focuses on hospital-at-home and alternative care models due to bed shortages and staffing issues. Hospital-at-home care, existing since 1995, gained recent attention as organizations struggle with patient...
The health care industry increasingly focuses on hospital-at-home and alternative care models due to bed shortages and staffing issues. Hospital-at-home care, existing since 1995, gained recent attention as organizations struggle with patient...
The health care industry...
01/19/2024
First Report Managed Care
Samantha Roushan
Interview
Innovating Prior Authorization With Responsible AI
10/27/2023
Sam Roushan
Sam Roushan, Senior Vice President of Clinical Transformation at Cohere Health, shares how responsible AI is informed with sound clinical knowledge and can stay within ethical and legal boundaries and benefit payers, providers, and patients.
Sam Roushan, Senior Vice President of Clinical Transformation at Cohere Health, shares how responsible AI is informed with sound clinical knowledge and can stay within ethical and legal boundaries and benefit payers, providers, and patients.
Sam Roushan, Senior Vice...
10/27/2023
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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