Managed Care

 

One Network Makes Comeback While Another Is Just Beginning

MANAGED CARE February 2012. © MediMedia USA
Editor's Memo

One Network Makes Comeback While Another Is Just Beginning

John Marcille
MANAGED CARE February 2012. ©MediMedia USA

John Marcille

Spring fever must have settled in early around here. You may notice two baseball references in our magazine and another in our online blog. The thought of baseball can warm the heart on a cold, snowy day. The blog item refers to a new forum where clinical executives can gather, kind of like the bar depicted in the TV show Cheers, where Sam Malone, a former Red Sox pitcher, served up various spirits to Boston patrons.

The first mention of baseball in this issue appears in our cover story. Contributing Editor Joseph Burns refers to the movie Moneyball in discussing why health plans are increasingly contracting with narrow networks of providers. Health care is like baseball, says Brett Morris of Health Net of Arizona, because officials like Morris are always trying to put together the best teams of providers, the “free agent” physicians and hospitals who can deliver high-value, low-cost care.

Not every provider can or should make the cut. Not in an era where the emphasis is on accountable care and patient-centeredness. As the consultant Paul H. Keckley, the subject of our Q&A, points out, clinical executives at health plans now have the hardest jobs, and are often the only voice with clinical training and experience in the room. They’re managers in every way.

Which brings us to our second baseball reference in a story announcing the launch of the Medical Directors Forum (MedicalDirectorsForum.com), the same one mentioned in the blog (www.managedcaremag.com). The analogy used is of baseball players sitting around discussing the art of hitting.

The online forum is a place where medical directors can talk with peers about many medical management topics. It’s also a source of governmental and many private companies’ guidelines that clinical executives sometimes have to consult to do their jobs. It’s somewhere they can go to get the encouragement and pick up a few pointers on matters of mutual interest.

Did you hear? Pitchers and catchers are going to be reporting any day now.

Meetings

Pharmaceutical Pricing and Contracting Conference Philadelphia, PA September 22–23, 2014
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