January 2010

Features

Cover Story

House Call Revival, Digital-Style
Telemedicine has different aspects, and one is the seemingly simple connection of a doc and a patient. When the stars are aligned, such an encounter can save money and time.
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How Plans Can Improve Outcomes And Cut Costs for Preterm Infant Care
Ten percent of newborns are admitted to a neonatal intensive care unit. NICU costs are high but controllable.
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Not Your Father’s Cadillac Plan
Just because a benefit package costs a lot doesn’t mean it pays for everything or improves outcomes. Many variables come into play.
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States Collect Valuable Data On Hospital Prices and Performance
Pennsylvania’s mining of infection info, and the use of insurers’ own statistics in Maine are seen as great examples of measuring quality
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Inpatient Rehab Facilities Benefit Post-Stroke Care
Rehabilitation at a skilled nursing facility lacks the intensity that most patients need, studies suggest
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Episode-of-Care Payment Creates Clinical Advantages
It is customary to think of this payment method as a cost-control mechanism, and it is, but it can raise quality of care too
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Higher Copayments and Deductibles Delay Medical Care, A Common Problem for Americans
CDHPs and catastrophic insurance plans can save consumers money, but do high deductibles add to overall costs down the line?
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Departments

Editor’s Memo

Looking Beyond Washington And Finding Much to Discuss
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Legislation & Regulation

Plans Scramble to Defend Their Medical Loss Ratios
Charges by lawmakers that insurers don’t spend enough on medical services lead to provisions in health reform bills in the Senate and House
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Medication Management

Strict Regulatory Environment Dogs Cancer Pain Management
Although effective treatments are available, helping patients cope is a minefield of administrative and legal barriers
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Compensation Monitor

Docs paid faster, with fewer claims denied
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The Formulary Files

Testing alternatives to prior authorization
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Tomorrow’s Medicine

New Anti-Asthma Treatment Smooths Muscle in Airways
If the Food and Drug Administration approves the bronchial thermoplasty system, it will be the first device specifically approved to treat the condition
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Plan Watch

Hospital Board Members Trained on Blues’ Dime
A unique health plan-provider partnership focuses on giving practical knowledge to those to whom the CEOs report
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Managed Care Outlook

Poor in Part D plans face more premiums in 2010
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News

Blues’ Payment Model Keeps Pace with Inflation    DIGITAL | HTML
EMRs Fall Short Of Docs’ Expectations    DIGITAL | HTML
Headlines On Deadline    DIGITAL | HTML
Hospital Costs Soar For 10 Procedures    DIGITAL | HTML
Mobile App Helps Members Find Docs    DIGITAL | HTML
Quality ratings of Medicare Advantage plans    DIGITAL | HTML