Whether they are $2 or $10 or nothing, HMO copayment amounts aren't just picked out of thin air. Because so much — from utilization rates to physician revenue — is at stake, setting copayments is a complicated process.
Last summer the American Diabetes Association proposed stronger screening guidelines months before the CDC reported the disease at an all-time high. Now managed care must decide whether to follow through.
Medication-related health problems afflict many patients and waste billions of dollars in treatment. Consultant pharmacists say they can help, and now have figures to back up their claim.
Some say it's too bad the managed care industry can't get together on a single accrediting and quality-rating agency for health plans. But the Joint Commission's president says it may actually be a blessing.
Responding to market pressures, many health plans are easing the referral process or eliminating it altogether. Will this trend result in higher costs and poorer medicine?