July 2010
Cover Story
Will the Employer-Based System Collapse?
Health reform adds to employers’ cost, giving them the reason to bail out, and health reform will set up health exchanges, giving them a cost-effective exit strategy
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Specialists Putting Mark On Strained Primary Care
With fewer PCPs, patients seek services from anyone, and that could raise utilization and costs
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Q&A
A Conversation with Larry S. Boress: Employers Want More Cooperation From Plans
The head of the Midwest Business Group on Health says insurers must pick up where PPACA left off
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Vaccination: Is 1 oz. of Prevention Still Worth 1 lb. of Cure?
Immunizations are a good deal for public health, but their growing number and rising costs pose a challenge for plans that must pay doctors for administering them
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Health Care Fraud Resistant to Reform
The Patient Protection and Affordable Care Act provides new initiatives to fight crooks and opportunists
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Peer-Reviewed
Comparison of Amlodipine/Valsartan Fixed-Dose Combination Therapy and Conventional Therapy
The use of a single-pill combination of amlodipine/valsartan resulted in higher acquisition costs but fewer clinic visits, laboratory tests, and electrocardiograms — and therefore lower gross costs — compared with the use of individual drug components
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Editor’s Memo
Businesses Need Reasons To Stay in Coverage Game
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Legislation & Regulation
Financed by the Feds, States Get Tougher on Rates
The law provides for premium reviews, but insurers say they’re afraid they’ll be hit with expensive challenges when efficiency is key
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Compensation Monitor
Concierge care at a discounted price
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The Formulary Files
Closed formulary keeps student-run clinic afloat
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Tomorrow’s Medicine
Prosthetic Hand Provides Nearly Normal Function
It might seem to be straight out of science fiction, but there’s solid science and engineering behind it
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Plan Watch
Medical Home Pilot Offers Docs Leeway
Blue Cross & Blue Shield of Oklahoma puts the emphasis on outcomes, rather than processes, and sweetens the pot with bonuses
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Managed Care Outlook
For heart drugs, greater generic penetration
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At-Home Monitors Help BP Control DIGITAL | HTML
Headlines On Deadline DIGITAL | HTML
Home Infusion Therapy Covered Well by Insurers DIGITAL | HTML
Hospital Costs Grow 25 Percent DIGITAL | HTML
Individual Premiums Rise 20 Percent DIGITAL | HTML
Single and family enrollment in high-premium plans DIGITAL | HTML
