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June 2009

Features

Cover Story

Employers Move Into Primary Care
As the number of onsite clinics at factories and office parks expands, will employers start to think they don't need managed care contracts?

Can a Medical ‘Facebook’ Help Your Plan Thrive?
Doctors share cases, brainstorms, and gripes in today’s fast-growing electronic physician communities, and pharma companies want to be a fly on the wall. So, experts say, should you.

Alzheimer’s Drug Pipeline Is Robust, And Usage Is Quickly Expanding
Drugs for comorbidities cost far more than the drugs for the condition itself

Liability Concern Balances Medical Tourism’s Cost Appeal
More employers and plan managers are looking at offshore options, but few are taking the plunge

Peer-Reviewed

Evaluating the Tools Used to Assess the Medical Home
Nine instruments were reviewed based on the extent that they measured the four attributes of primary care. Only one fully met the recommended criteria.

Departments

Editor’s Memo
With Workplace Clinics, What’s Old Is New

Legislation & Regulation
The Long Road to Level 1
The switch to EDI’s 5010 data interchange standards requires full readiness — called level 1 by those in the know — in 2½ years. Let the scrambling begin.

Snapshot
Administrative tasks related to managed care cost physician practices $31 billion per year

Compensation Monitor
Perhaps health plans should collaborate on P4P

Formulary Files
Retail and mail copayments on the rise

Tomorrow’s Medicine
Knee Replacement Procedure Means Less Stress, Bone Loss
Unicompartmental joint operation doesn’t require storing various joint fittings to accommodate each patient's anatomy

Plan Watch
Military’s Blog Helps Cut Through Fog of Care
Tricare saves itself unnecessary grief by reaching out to beneficiaries who need only call up http://www.health.mil/TMABlog/

Managed Care Outlook
Six therapeutic categories account for most drug costs

News

Patient Hospital Transitions Interrupt Continuity of Care
Searching World for Effective Care
Medicare spending projections over the next decade
Market Turmoil Takes Toll
IRS Issues New HSA Limits
Headlines on Deadline

Oral Anticoagulation Patient Self-Testing: Consensus Guidelines For Practical Implementation

Warfarin’s narrow therapeutic range, variable biological effects, and potential for food and drug interactions present challenges in managing oral anticoagulation therapy with warfarin. Patient self-testing has been shown to result in significant benefits for patients and their families, health care practitioners, and health care systems.

Highlights:
  • Rationale for Wider Implementation of Patient Self-Testing
  • Patient Self-Testing Costs and Related Reimbursement
  • Practical Guidelines for Implementation of Patient Self-Testing
  • Summary of Consensus Panel Recommendations

Opioids in the Workplace

Advances in treatment have helped patients manage chronic pain with pharmaceutical pain relievers, but some drugs — particularly opioids — carry the risk of dependence. Opioid dependence is a medical condition, and it can be treated, but employers may not know about all the treatments that are now available, or that they are covered by most health plans.

Not only are treatments covered by insurance, but the Americans with Disabilities Act and the Drug Addiction Treatment Act, passed by Congress in 2000, encourage employers to support employees with opioid dependency. Qualifying physicians may now treat opioid dependence directly, letting the abuser seek help in the privacy of a physician’s office rather than at a public clinic.

Highlights

  • How opioids hijack the brain
  • Ways in which employers deal with dependence
  • Successful approaches to treatment
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