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Behind the Bill
New Bill Would Expand Medicare and Medicaid Access to Community Health Workers
09/18/2026
Hannah Musick
The Community Health Worker Access Act would expand Medicare reimbursement for community health worker services and incentivize states to broaden Medicaid coverage, potentially strengthening care navigation, preventive support, and...
The Community Health Worker Access Act would expand Medicare reimbursement for community health worker services and incentivize states to broaden Medicaid coverage, potentially strengthening care navigation, preventive support, and...
The Community Health Worker...
09/18/2026
First Report Managed Care
News
US Vitiligo Study Finds Short Treatment Duration, Variable Care Patterns
09/18/2026
Grace Taylor, MS, MA
A study found that US patients with vitiligo showed short treatment durations and highly variable treatment patterns, while approximately one-third received no treatment following diagnosis.
A study found that US patients with vitiligo showed short treatment durations and highly variable treatment patterns, while approximately one-third received no treatment following diagnosis.
A study found that US patients...
09/18/2026
First Report Managed Care
News
GLP-1 Coverage Linked to Higher Utilization and Costs in Employer-Sponsored Health Plans
09/17/2026
Rebecca Amrick
Researchers found that between 2021 and 2024, utilization of glucagon-like peptide-1 (GLP-1) medications increased among patients with obesity, with greater growth among plans providing coverage for GLP-1 drugs.
Researchers found that between 2021 and 2024, utilization of glucagon-like peptide-1 (GLP-1) medications increased among patients with obesity, with greater growth among plans providing coverage for GLP-1 drugs.
Researchers found that between...
09/17/2026
First Report Managed Care
News
Epcoritamab Plus R2 Demonstrates Long-Term Cost-Effectiveness in Relapsed or Refractory FL
09/17/2026
Rebecca Amrick
A cost-effectiveness analysis indicated that adding epcoritamab to lenalidomide plus rituximab (R2) could reduce long-term health care spending for patients with relapsed or refractory follicular lymphoma (FL).
A cost-effectiveness analysis indicated that adding epcoritamab to lenalidomide plus rituximab (R2) could reduce long-term health care spending for patients with relapsed or refractory follicular lymphoma (FL).
A cost-effectiveness analysis...
09/17/2026
First Report Managed Care
News
Fewer PA Requirements Among System-Affiliated MA Health Plans
09/16/2026
Rebecca Amrick
Medicare Advantage (MA) plans affiliated with health systems had fewer prior authorization (PA) requirements than unaffiliated plans, with the largest differences observed for behavioral and mental health services and dialysis.
Medicare Advantage (MA) plans affiliated with health systems had fewer prior authorization (PA) requirements than unaffiliated plans, with the largest differences observed for behavioral and mental health services and dialysis.
Medicare Advantage (MA) plans...
09/16/2026
First Report Managed Care
News
Monitoring Ruxolitinib Responses Could Optimize Treatment for Polycythemia Vera
09/16/2026
Rebecca Amrick
Monitoring spleen and hematologic responses in patients with ruxolitinib-treated polycythemia vera (PV) enabled researchers to develop a prognostic model that may help physicians identify patients at increased risk of poor outcomes.
Monitoring spleen and hematologic responses in patients with ruxolitinib-treated polycythemia vera (PV) enabled researchers to develop a prognostic model that may help physicians identify patients at increased risk of poor outcomes.
Monitoring spleen and...
09/16/2026
First Report Managed Care
News
The Impact of Atopic Comorbidities on Health Care Utilization for Atopic Dermatitis
09/15/2026
Rebecca Amrick
New research suggests an association between atopic comorbidities and health care utilization and costs among young children with atopic dermatitis.
New research suggests an association between atopic comorbidities and health care utilization and costs among young children with atopic dermatitis.
New research suggests an...
09/15/2026
First Report Managed Care
News
Real-World Study Identifies Factors Associated With Successful TKI Discontinuation in CML
09/14/2026
Rebecca Amrick
Among patients with CML who discontinued TKI therapy, sustained deep molecular response, lower Sokal scores, and longer treatment duration were associated with a greater likelihood of maintaining treatment-free remission.
Among patients with CML who discontinued TKI therapy, sustained deep molecular response, lower Sokal scores, and longer treatment duration were associated with a greater likelihood of maintaining treatment-free remission.
Among patients with CML who...
09/14/2026
First Report Managed Care
Behind the Bill
House Panel Weighs Medicare Payment Reform and Health Care Cybersecurity Legislation
09/14/2026
Hannah Musick
A House panel is weighing bipartisan proposals that could reshape Medicare physician payments and strengthen health care cybersecurity, with potential implications for provider reimbursement, value-based care, network stability, and cyber...
A House panel is weighing bipartisan proposals that could reshape Medicare physician payments and strengthen health care cybersecurity, with potential implications for provider reimbursement, value-based care, network stability, and cyber...
A House panel is weighing...
09/14/2026
First Report Managed Care
News
The Cost-Effectiveness of the JAKPOT Prediction Rule for Erythrocytosis
09/11/2026
Rebecca Amrick
Researchers found upfront JAK2 testing to be more cost-effective in US settings than the JAKPOT predication rule when identifying JAK2 mutations among patients with erythrocytosis.
Researchers found upfront JAK2 testing to be more cost-effective in US settings than the JAKPOT predication rule when identifying JAK2 mutations among patients with erythrocytosis.
Researchers found upfront JAK2...
09/11/2026
First Report Managed Care

Pipeline Projections

PIPELINE PROJECTIONS
The Evolving Alzheimer Disease Treatment Landscape: Anti-Amyloid Therapies and Beyond
07/21/2026
Roy Moore
Roy Moore explores the evolving Alzheimer's disease pipeline, highlighting the promise of anti-amyloid therapies, emerging competitors, and the challenges ahead.
Roy Moore explores the evolving Alzheimer's disease pipeline, highlighting the promise of anti-amyloid therapies, emerging competitors, and the challenges ahead.
Roy Moore explores the evolving...
07/21/2026
First Report Managed Care
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

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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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