Using Option-Based Contracts to Improve Health Outcomes
A system in which individual insurance policies may be purchased for separate medical products and services is based on a medical options market and takes its cue from the financial sector
Damon Douglas, dual PharmD/MBA candidate ABSTRACT | PDF |
In Chronic Disease, Nationwide Data Show Poor Adherence by Patients to Medication and by Physicians to Guidelines
A widespread approach that incorporates various stakeholders may be necessary to change adherence behavior
Sara L. Thier, MPH, Kristina S. Yu-Isenberg, PhD, MPH, RPh, Brian F. Leas, MS, MA, C. Ron Cantrell, PhD, Sandra DeBussey, Neil I. Goldfarb, David B. Nash, MD, MBA ABSTRACT | PDF |
Optimizing the Use of 17P In Pregnant Managed Medicaid Members
Mary V. Mason, MD, MBA, Kara M. House, MBA, Janice Linehan, PA-C, MHP, Carol A. Speers, RN, Lisa M. Joseph, RN, MBA, Ray Littlejohn ABSTRACT | PDF |
Evolution of TennCare Yields Valuable Lessons
The old TennCare program had many flaws and detractors. Its near collapse led to a more realistic approach to providing coverage to the uninsured in Tennessee.
Cyril F. Chang, PhD ABSTRACT | PDF |
Comparison of Human Growth Hormone Products' Cost in Pediatric and Adult Patients
Payers' drug costs for human growth hormone are related to product waste that is related to the container in which the product is supplied
Gary R. Bazalo, MS, Ashish V. Joshi, PhD, John Germak, MD ABSTRACT | PDF |
Determining the Cost-Effectiveness of a Computer-Based Smoking Cessation Intervention in Primary Care
Meredith Y. Smith, PhD, Purdue Pharma, Stamford, Conn., Jerry Cromwell, PhD, Research Triangle Institute, Research Triangle Park, N.C., Judith DePue, EdD, Miriam Hospital/Brown Medical School, Providence, R.I., Bonnie Spring, PhD, Northwestern University, Chicago, Ill., William Redd, PhD, Mount Sinai School of Medicine, New York, N.Y., Marina Unrod, PhD, Mount Sinai School of Medicine, New York, N.Y. ABSTRACT | PDF |
The Appropriate Omalizumab Patient
Management of the uncontrolled asthma patient and case examples
Jill Karpel, MD, Donald A. Bukstein, MD, Robert LoNigro ABSTRACT | PDF |
Applying the Planned Care Model To Intimate Partner Violence
Implementing what was formerly called the Chronic Care Model can improve an organization's response to this widespread problem
Therese Zink, MD, MPH, Karen Lloyd, PhD, LP, George Isham, MD, David J. Mathews, PsyD, LICSW, Terry Crowson, MD ABSTRACT | PDF |
The Use of Therapeutic Interchange For Biologic Therapies
Joseph Flood, MD, FACR, Charles Mihalik, PharmD, RPh, Renee R. Fleming, RPh, MBA, Bruce E. Strober, MD, PhD, Deborah R. Zucker, MD, PhD, Douglas S. Burgoyne, PharmD, RPh ABSTRACT | PDF |
Implementing Disease Management Programs for Type 2 Diabetes in Germany
Germany has been able to enroll more than a million people with type 2 diabetes in DM programs through legislation that created incentives for physicians and insurers
Heinz Nagel, MD, Thomas Baehring, PhD, Werner A. Scherbaum, MD, PhD ABSTRACT | PDF |
Compliance With Antithrombotic Guidelines: Current Practice, Barriers, and Strategies For Improvement
Deeply held, but not evidence-based, concerns about the possible risks of pharmacologic prophylaxis leave many patients at risk for DVT
Joseph A. Caprini, MD, Thomas M. Hyers, MD, FCCP ABSTRACT | PDF |
When Overcrowding Paralyzes an Emergency Department
Changing the process and mindset of health care professionals was the key to reducing emergency department overcrowding
Joseph R. Twanmoh, MD, FACEP, Gail P. Cunningham, MD, FACEP ABSTRACT | PDF |
The Cost-Effectiveness of Omega-3 Supplements For Prevention of Secondary Coronary Events
Dietary supplementation with omega-3 fatty acids in U.S. males is associated with fewer cardiovascular fatalities and lower costs
Jordana K. Schmier, MA, Nancy J. Rachman, PhD, Michael T. Halpern, MD, PhD ABSTRACT | PDF |
The Cost Benefit to Health Plans of Pharmacotherapy for Alzheimer's Disease
As with other chronic diseases of aging, early diagnosis and pharmacologic therapy may reduce the costs for enrollees with Alzheimer's disease
David S. Geldmacher, MD ABSTRACT | PDF |
17 Alpha-Hydroxyprogesterone Caproate (17P) Usage in a Medicaid Managed Care Plan and Reduction in Neonatal Intensive Care Unit Days
Offering 17P as a benefit to pregnant women enrollees with a history of preterm delivery can reduce NICU days significantly for a Medicaid plan.
Mary V. Mason, MD, MBA, Kara M. House, BS, MBA, Cathy M. Fuest, RPh, Deborah R. Fitzgerald, RN, Bonnie J. Kitson, MBA, Jacqueline A. Inglis, RN, BSN, MM ABSTRACT | PDF |
Evaluating the Nondrug Costs of Formulary Coverage Restrictions
Substantial nondrug costs result from switching prescribed medications in response to changes in insurance coverage, and many nonreimbursed costs shift to providers and patients.
Paul Abourjaily, PharmD, William A. Gouveia, MS, Harry P. Selker, MD, MSPH, Deborah R. Zucker, MD, PhD ABSTRACT | PDF |
Consumer-Directed Health Plans: Enrollee Views, Early Employer Experience
As CDHPs increasingly penetrate the commercial market , their greatest contribution might lie in funding health services for retirees and in reducing the number of uninsured people by offering affordable insurance.
Janice Frates, PhD, Ellen Severoni, RN ABSTRACT | PDF |
Clinical and Economic Effects of Coronary Restenosis After Percutaneous Coronary Intervention in a Managed Care Population
This study is the first to estimate costs and medical resource use associated with restenosis involving bare metal stents in managed care percutaneous coronary intervention patients.
Mary Ann Clark, MHA, Ameet Bakhai, MD, Elise M. Pelletier, MS, David J. Cohen, MD, MSc ABSTRACT | PDF |
Managing Drugs for Rare Genetic Diseases: Trends and Insights
This article evaluates recent trends and challenges in health system management of exceedingly rare genetic diseases, from the perspective of the manufacturer, managed care organization, physician, and actuary.
Mark Zitter, MBA ABSTRACT | PDF |
Measuring Outpatient Outcomes of Emesis and Nausea Management in Pregnant Women
In this study, outpatient management was effective in controlling nausea and vomiting during pregnancy and was associated with a reduced need for hospital or emergency room treatment as well as reduced costs.
David G. Lombardi, MD, Niki B. Istwan, RN, Debbie J. Rhea, MPH, John M. O'Brien, MD, John R. Barton, MD ABSTRACT | PDF |
Evaluating New Therapies for Psoriasis
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Cost-effective Management of Hyperglycemia in Patients With Type 2 Diabetes Using Oral Agents
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Advances in Migraine Management: Implications for Managed Care Organizations
David W. Dodick, MD, Robert J. Lipsy, PharmD ABSTRACT | PDF |
IgE-Blocking Therapy for Difficult-to-Treat Asthma: A Brief Review
Gailen D. Marshall Jr., MD, PhD, Christine A. Sorkness, PharmD ABSTRACT | PDF |
Improving Oral Pharmacologic Treatment And Management of Type 2 Diabetes
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Treating Psoriasis Patients With Biologic Agents
David M. Pariser, MD, Jeffrey Lenow, MD, JD ABSTRACT | PDF |
Case Study of a Failed Merger of Hospital Systems
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Balancing the Health Care Scorecard
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Managing Perinatal Outcomes: The Clinical Benefit and Cost-Effectiveness of Pharmacologic Treatment of Recurrent Preterm Labor
Fung Lam, MD, Niki B. Istwan, RN, BS, Debbie Jacques, MPH, Suzanne K. Coleman, RNC, MS, Gary J. Stanziano, MD ABSTRACT | PDF |
A Health Care Management Company's Experience With Palivizumab -- 1 Year Later
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Management of Moderate to Severe Plaque Psoriasis with Biologic Therapy
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Economic Analysis of Oral and Topical Therapies for Onychomycosis of the the Toenails and Fingernails
Julian Casciano, Karine Amaya, PhD, John Doyle, MPH, Steve Arikian, MD, Neil Shear, MD, Marc Haspel, DPM, Kristijian Kahler ABSTRACT | PDF |
The Quandary of Compounding for MCOs: Administrative Costs, Risks, and Waste
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Measuring Efficiency of Physician Practices Using Data Envelopment Analysis
Steven Andes, PhD, CPA, Lawrence M. Metzger, PhD, CPA, John Kralewski, PhD, David Gans, MSHA ABSTRACT | PDF |
Is 34 Weeks an Acceptable Goal For a Complicated Singleton Pregnancy?
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Examining Costs of Chronic Conditions In a Medicaid Population
Robert I. Garis, RPh, PhD, Kevin C. Farmer, PhD ABSTRACT | PDF |
Diabetes Disease Management in a Community-Based Setting
Gregory D. Berg, PhD, Sandeep Wadhwa, MD, MBA ABSTRACT | PDF |
Estimating Pediatric Primary Care Provider Visits In a Capitated Environment: Encounter vs. Claims Databases
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The Effect of Practitioner Compensation on HMO Consumer Satisfaction
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An In-Office Diagnostic Procedure To Detect Dermatophytes In a Nationwide Study of Onychomycosis Patients
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Reframing the Pharmaceutical Manufacturer/Health Plan Relationship in Managed Care
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A Health Care Management Company's Experience with Palivizumab
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Telemedicine: Cost-Effective Management of High-Risk Pregnancy
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Managed Care Trends in Statin Usage
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Memoranda of Understanding Between Medicaid MCOs and Public Health Departments
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Satisfaction and Patient Outcomes of a Telephone-Based Nurse Triage Service
Joan M. O'Connell, Ph.D., M.H.S., Jack L. Stanley, B.A., C. Lucy Malakar, M.A. ABSTRACT | PDF |
Inter-Rater Reliability Testing For Utilization
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A Critical Review of the Arguments for Insurance Coverage for Smoking-Cessation Therapies
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An Evidence-Based Evaluation of Percutaneous Vertebroplasty
Susan A. Levine, D.V.M., Ph.D., Lawrence A. Perin, M.D., M.B.A., Diane Hayes, Ph.D., Winifred S. Hayes, Ph.D. ABSTRACT | PDF |
