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Commentary

Real-World Data, Artificial Intelligence, Health Care
Commentary
Powering Actionable Insights With Real-Time RWD Dashboards
02/11/2026
Sujay Jadhav
Health care generates massive amounts of real-world data (RWD), and that volume is only continuing to expand. By 2030, the global big data analytics market is expected to reach nearly $350 billion, with health care driving much of that...
Health care generates massive amounts of real-world data (RWD), and that volume is only continuing to expand. By 2030, the global big data analytics market is expected to reach nearly $350 billion, with health care driving much of that...
Health care generates massive...
02/11/2026
First Report Managed Care
Long-Term Care, Post-Acute Care, Lobbying, Politics
Commentary
All Politics Is Local—Why Long-Term and Post-Acute Care Leaders Should Participate in Grassroots Advocacy
01/20/2026
Bill Charnetski
Local long-term and post-acute care leaders can’t afford to sit out politics—by embracing grassroots advocacy, sharing their expertise, and building relationships with lawmakers, they can directly shape the policies that affect their...
Local long-term and post-acute care leaders can’t afford to sit out politics—by embracing grassroots advocacy, sharing their expertise, and building relationships with lawmakers, they can directly shape the policies that affect their...
Local long-term and post-acute...
01/20/2026
Annals of Long-Term Care
Regulatory Insights
Subsidies, Savings, and Stalemates: What Congress's Year-End Gridlock Means for Health Plans in 2026
12/05/2025
Adam Colborn, JD
As health policy debates resurface in Washington, unresolved battles over ACA subsidies, health savings accounts, and PBM reform are shaping a high-stakes landscape for payers heading into the new year.
As health policy debates resurface in Washington, unresolved battles over ACA subsidies, health savings accounts, and PBM reform are shaping a high-stakes landscape for payers heading into the new year.
As health policy debates...
12/05/2025
First Report Managed Care
Cell & Gene Watch
Reaching Patients Where They Are: Moving CGT Care into the Community
12/05/2025
Joe DePinto
As cell and gene therapies rapidly advance, shrinking the nation’s growing “CGT deserts” by expanding capabilities in community care settings is essential to ensure that breakthrough treatments reach patients equitably—not just those living...
As cell and gene therapies rapidly advance, shrinking the nation’s growing “CGT deserts” by expanding capabilities in community care settings is essential to ensure that breakthrough treatments reach patients equitably—not just those living...
As cell and gene therapies...
12/05/2025
First Report Managed Care
Jadhav headshot
Commentary
Data Doesn’t Save Lives. Insight Does.
12/05/2025
Sujay Jadhav
Real-world data alone cannot advance drug development; only expertly curated, clinically grounded insight can drive meaningful improvements in clinical trials.
Real-world data alone cannot advance drug development; only expertly curated, clinically grounded insight can drive meaningful improvements in clinical trials.
Real-world data alone cannot...
12/05/2025
First Report Managed Care
Commentary
Biologics: Combating Big Spend in Small Doses
11/24/2025
Krithika Srivats
A guest expert discusses how biologic drugs like monoclonal antibodies are driving soaring health care costs, but data-driven strategies and greater use of biosimilars may offer payers a powerful path to rein in spending without compromising...
A guest expert discusses how biologic drugs like monoclonal antibodies are driving soaring health care costs, but data-driven strategies and greater use of biosimilars may offer payers a powerful path to rein in spending without compromising...
A guest expert discusses how...
11/24/2025
First Report Managed Care
Commentary
Exploring Power Imbalances in Managed Care
10/24/2025
Kevin Thilborger
Private insurers’ unchecked market dominance is straining providers with below-inflation reimbursement, rising administrative hurdles, and regulatory inaction—pressuring hospitals to consolidate, fueling care delays, and prompting urgent...
Private insurers’ unchecked market dominance is straining providers with below-inflation reimbursement, rising administrative hurdles, and regulatory inaction—pressuring hospitals to consolidate, fueling care delays, and prompting urgent...
Private insurers’ unchecked...
10/24/2025
First Report Managed Care
Vashi Headshot
Commentary
How Health Insurers Can Implement AI Tools
10/06/2025
Deepan Vashi
This series has covered how health insurers can see real benefit from artificial intelligence (AI) in claims processing, appeals and grievances, member care, risk adjustment, and quality. In our final segment, we look at best practices for...
This series has covered how health insurers can see real benefit from artificial intelligence (AI) in claims processing, appeals and grievances, member care, risk adjustment, and quality. In our final segment, we look at best practices for...
This series has covered how...
10/06/2025
First Report Managed Care
Pratt Headshot
Commentary
Time: The Critical Resource Rural Hospitals Can’t Afford to Waste
09/26/2025
Mark Pratt
Rural health care staff members don’t just wear many hats—they often wear them all at once. In many communities, one person might be handling registration, billing, and collections while also answering phones or covering a front desk. When...
Rural health care staff members don’t just wear many hats—they often wear them all at once. In many communities, one person might be handling registration, billing, and collections while also answering phones or covering a front desk. When...
Rural health care staff members...
09/26/2025
First Report Managed Care
Holt Headshot
Commentary
Escaping the Black Hole: Why Post-Acute Blind Spots Are Hospitals’ Biggest Value-Based Risk
09/26/2025
Steve Holt
To succeed under new CMS value-based care models, hospitals must close the “post-acute black hole” by improving data exchange, strengthening care transitions, building high-quality post-acute partnerships, and leveraging predictive and...
To succeed under new CMS value-based care models, hospitals must close the “post-acute black hole” by improving data exchange, strengthening care transitions, building high-quality post-acute partnerships, and leveraging predictive and...
To succeed under new CMS...
09/26/2025
First Report Managed Care

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

Trending Articles

News
Latest Formulary Exclusions from Top PBMs Demonstrate Issues in the Drug Pricing Landscape
02/21/2024
Dean Celia
Experts highlight the impact of the "warped incentives" in drug pricing's gross-to-net bubble, revealing that despite significant discounts, certain biosimilars are excluded from the formularies of major pharmacy benefit managers, leading to...
Experts highlight the impact of the "warped incentives" in drug pricing's gross-to-net bubble, revealing that despite significant discounts, certain biosimilars are excluded from the formularies of major pharmacy benefit managers, leading to...
Experts highlight the impact of...
02/21/2024
First Report Managed Care
Owens
Podcasts
Understanding the Impact of Formulary Exclusions on Medication Adherence
03/28/2024

Featuring Gary Owens, MD, president of Gary Owens Associates

Featuring Gary Owens, MD, presid...
Join us as guest expert Gary Owens discusses how formulary exclusions can impact patient medication adherence and lead to adverse economic outcomes, making the need for non-medical switching and formulary exception requests an important issue...
Join us as guest expert Gary Owens discusses how formulary exclusions can impact patient medication adherence and lead to adverse economic outcomes, making the need for non-medical switching and formulary exception requests an important issue...
Join us as guest expert Gary...
03/28/2024
First Report Managed Care
Conference Coverage
Pharmaceutical Industry Trend and Prediction Highlights from AMCP 2024
04/26/2024
Hannah Musick
A keynote session at AMCP 2024 outlined pharmaceutical industry trends and predictions for pharmacy benefits management (PBMs), including challenges and disruptors like the Inflation Reduction Act (IRA), changing consumer preferences, rising...
A keynote session at AMCP 2024 outlined pharmaceutical industry trends and predictions for pharmacy benefits management (PBMs), including challenges and disruptors like the Inflation Reduction Act (IRA), changing consumer preferences, rising...
A keynote session at AMCP 2024...
04/26/2024
First Report Managed Care
News Connection
Navigating the Inflation Reduction Act's Impact on Drug Pricing and Health Care
05/29/2024
Dean Celia
During a recent webinar hosted by the Drug Channels Institute, Adam Fein, PhD, discussed the specifics of the Inflation Reduction Act (IRA) and its potential impacts and timeline. First Report Managed Care connected with other managed care...
During a recent webinar hosted by the Drug Channels Institute, Adam Fein, PhD, discussed the specifics of the Inflation Reduction Act (IRA) and its potential impacts and timeline. First Report Managed Care connected with other managed care...
During a recent webinar hosted...
05/29/2024
First Report Managed Care
Ryan Bosch
Interview
Breaking Down Barriers: Understanding the Impact of Social Determinants of Health (Part 1)
07/09/2024
Discover how social determinants of health have historically been overlooked in healthcare, the obstacles preventing professionals from addressing them, and the potential consequences of reducing policy support in this eye-opening interview...
Discover how social determinants of health have historically been overlooked in healthcare, the obstacles preventing professionals from addressing them, and the potential consequences of reducing policy support in this eye-opening interview...
Discover how social determinants...
07/09/2024
First Report Managed Care

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