Managed Care

 

With Wing and Prayer, But Without a Blueprint

MANAGED CARE April 2007. © MediMedia USA
Editor's Memo

With Wing and Prayer, But Without a Blueprint

John Marcille
MANAGED CARE April 2007. ©MediMedia USA

John Marcille

We're all over the place, this month. A magazine can be compared to a car that's assembled by engineers challenged to build something without a blueprint. What emerges will run, often very well, but who knows what it will look like?

This month we're surprised, again, by just how much a many-tentacle thing is managed care. Our managed care car takes us to far-flung places, such as those featured in our article on medical tourism, or into laboratories to find out just what health plans pay for and what they should demand, and to the P&T committee meeting table, where we discover that the clinicians guiding those panels sometimes do not have information about drug prices.

For theorists, there's our interview with McKesson's Emad Rizk, who sees a very different disease management on the horizon. Meanwhile, some marquee names in health care economics ponder, just what the world would look like if managed care had never been invented. "To be, or not to be...."

However, before that, you may want to read the cover story. Author John Carroll looks at an industry that is being reduced to a few big players in each market.

What does that mean for regional operators? Or quality? Or providers? Some who contract with insurers fear the consequences of consolidation. Are they warnings or are they threats? Our cover illustration, two well-dressed business titans locked in battle, may represent two huge health plans. Or, it may represent one huge health plan and one huge hospital company. Of particular concern is that little person pictured amongst the giants — the member?

Either way, it's a fight. We'll keep giving you the blow-by-blow.

Meetings

Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014