Managed Care



January 2005

PET, CT, MRI — these and other imaging technologies are valuable but costly. Aetna, Cigna, and a few other plans lead in clamping down on unnecessary use.
Maureen Glabman
Some of the nation's best health plans are coming up with creative ways to encourage women to get mammograms.
Sharon Baker
The private sector drags its feet over Ambulatory Payment Classifications. Here are some suggestions to move acceptance along.
Renee Leary, MPH ; Dean Farley, PhD
The health plan was listing badly when Charles Baker boarded it in 2000. Since then, the ship has been righted and the way is clear.
Ed Silverman
Pay-for-performance (P4P) programs promise a fair shake for provider and plan, but a former chairman of the NCQA sees many design flaws to overcome.
Alice G. Gosfield, JD
The physician-author of “Overdosed America” says that health plans have a logical role in actively assessing the medical literature.
A federal agency fashioned to oversee drug research might inhibit the creation of new medications. The quest for profit in itself may generate benefit.
Martin Sipkoff

Legislation & Regulation
The $50 million needed for regional collaborations was not part of the federal government's budget. Not the end of the world, but not good either.
John Carroll
Tomorrow's Medicine
Natalizumab has received FDA approval. But as with all approved treatments, questions remain about efficacy and clinical importance compared to existing therapies.
Thomas Morrow, MD


4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium 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
HealthIMPACT Southeast Tampa, FL January 23, 2015