Managed Care

 

 

August 2004

The accepted insurance model is to provide care intended to make sick people well. This might include screening, and some preventive actions such as immunizations. But there are new arguments that small investments in persuading people to live healthier lifestyles will result in large reductions in cost in later years.
MargaretAnn Cross
Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
Martin Sipkoff
Deciding to seek NCQA accreditation sets an HMO up for lots of preparatory work. Make sure the effort is well spent.
Bob Carlson
Physicians who make the move to the administrative side find a lot of tough decisions waiting for them.
Marilyn Bydalek
Yes, health care is a business, but altruistic plans would like to cooperate with others. The Leapfrog Group has set up a simple mechanism to do this.



Departments
Editor's Memo
John A. Marcille
Viewpoint
Only a small percent of a typical health plan's population takes medicine for conditions outside the generalist's scope. But it's a big portion of the drug bill.
Alan Lotvin
Ethics
When physicians think it is acceptable to withhold care from lawyers involved in malpractice suits, does it signal a breakdown of the social order?
Michael S. Victoroff, MD
Legislation & Regulation
The senate majority leader, a surgeon who owns a large stake in a chain of hospitals, puts forth far-reaching proposals for reforming the health care system.
John Carroll
Employer Update
Companies test new approaches to funding the pharmacy benefit with the goal of saving money overall.
MargaretAnn Cross
TOMORROW'S MEDICINE
Diseases will soon be defined by biochemical pathways and genetic interactions. Biochips may identify patients likely to respond to therapeutic agents.
Thomas Morrow, MD

Meetings

2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
6th Semi-Annual Diagnostic Coverage and Reimbursement Conference Boston December 4–5, 2014
Customer Analytics & Engagement in Health Insurance Chicago December 4–5, 2014
Pharmaceutical and Biotech Clinical Quality Assurance Conference Alexandria, VA December 4–5, 2014
9th Semi-Annual Medical Device Coverage and Reimbursement Conference San Diego December 5, 2014
8th Annual Medical Device Clinical Trials Conference Chicago December 8–9, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015