First Report Managed Care

Key Clinical Summary: In the phase 3 TRuE-AD4 trial, 70.0% of adults receiving 1.5% ruxolitinib cream achieved at least a 75% improvement in Eczema Area and Severity Index (EASI-75) scores at week 8, compared with 18.5% receiving vehicle. Ruxolitinib cream provided rapid itch relief, with significantly more patients achieving at least a 4-point improvement in itch severity by day 2 and differences in current itch relief observed as early as 15 minutes after the first application.

Key Takeaways: Most services had lower utilization in the full-risk cohort than in the nonrisk cohort, although utilization patterns varied across individual services. A simulated Medicare fee schedule based on risk benchmarks resulted in a possible 6% payment increase for general practice physicians. These findings illustrate the potential of full-risk contracts in identifying service utilization patterns and informing physician fee schedule reforms.

JavaScript is disabled in your browser. Please enable JavaScript to proceed. A required part of this site couldn’t load. This may be due to a browser extension, network issues, or browser settings. Please check your connection, disable any ad blockers, or try using a different browser.

Key Takeaways: Implied rebates below the annual average: In an analysis of Medicare Advantage (MA) monthly rebates, calculations based on spending reductions alone yielded lower rebates than the actual 2024 average. Coding and selection raised rebates: After including the impact of coding and favorable selection, implied rebates increased and were closer to the observed average.

Key Takeaways: Emergency department (ED) use among older adults is influenced by an aging population and the accessibility and convenience of emergency care. Incomplete information and poor communication during transitions between EDs and skilled nursing facilities (SNFs) can contribute to delayed care, avoidable complications, and repeat visits.

JavaScript is disabled in your browser. Please enable JavaScript to proceed. A required part of this site couldn’t load. This may be due to a browser extension, network issues, or browser settings. Please check your connection, disable any ad blockers, or try using a different browser.

Can you please share your name, title, and a brief overview of your professional history? Rakshith Yashvanth: I'm Rakshith Yashvanth, senior product manager at ZeOmega, where I work on artificial intelligence (AI) and social care capabilities within care management, utilization management, and population health platforms used by health plans and Medicaid managed care organizations.

As we approach the 2026 midterm elections, members of Congress are working hard to spotlight actions they have taken or will take if their party wins control next year. Many are touting their ability to work across the aisle on bipartisan policy solutions. As always, health care is a major focus in campaign messaging.

Travis Morgan, CPA, MBA: My name is Travis Morgan. I’m the President and Co-Founder of DecisionRx. I’m a certified public accountant (CPA) and have a Master of Business Administration (MBA). I’ve spent almost 30 years in the precision diagnostics and health technology space. Could you share a brief overview of the study and some of its key findings? Morgan: There are many studies that quantify the impact of using a pharmacist to guide prescribing and show that doing so saves money.