May 2005

Cover Story

Are Consumers Really Directing Their Own Care?
In theory, consumer-directed health plans put the reins of decision making into the hands of their members. But medical management departments are alive and well inside CDHPs — and may even expand under these plan designs.

MargaretAnn Cross

Hospitals May See Plans as Their New Confidant
Not only can health plans pay for performance, they can offer a mechanism for confidential discussions of mistakes.

Frank Diamond

Evaporation of Retiree Benefits May Be Health Plan Opportunity
With big companies steadily reducing coverage for retirees, plans need to devise products for this needy population.

John Carroll

Q&A

A Conversation With Richard Stefanacci, DO: Implementing Medicare Part D Could Get Ugly
This expert who hopes to help everybody adjust nevertheless expects big headaches come Jan. 1, 2006. However, e-prescribing could make the drug plan work.

Patrick Mullen

Predictive Modeling & Genomics: Marriage of Promise and Risk
Integration of predictive modeling and genomic tools means improved technology, enhanced databases, and appropriate legal guidance.

Martin Sipkoff

Editor’s Memo

Providing Medical Management In Consumer-Directed Plans

John A. Marcille

Legislation & Regulation

With More Enthusiasm Than Money, Brailer Pushes Nationwide EMR System
David Brailer, MD, PhD, the nation's health information chief, wants the industry, not the government, to devise a system that provides interoperability.

John Carroll

Medication Management

Health Plans Undaunted By Medicare Part D
Despite the seeming Gordian knot of regulations associated with Medicare Part D, health plans figure the benefit-to-risk ratio is squarely in their favor.

Martin Sipkoff

Ethics

Class Action Suit: Windfall or Just Wind?
Is using the tort system and class action lawsuits the best way to solve problems between business professionals? That and $54.37 can go toward the creation of a foundation to bring about meaningful organizational change.

Michael S. Victoroff, MD

Compensation Monitor

New model, more money for family docs
The Formulary Files

Antiretroviral coverage lacking in 30 percent of ADAPs
Tomorrow’s Medicine

Microcircuit Devices Deliver Considerable Relief From Chronic Pain
Recent advances in pain relief revolve around longer-lasting implantable devices. Can you afford not to have a pain management strategy?

Thomas Morrow, MD

Managed Care Outlook

Covering the uninsured seen as legislative priority
Opinion leaders say Congress should also act to improve quality and safety, and ensure Medicare solvency.



News & Commentary

Health care remains a major concern

Company Offers To Manage Durable Medical Equipment Costs

Medicare PPOs Face Challenge to Funding

Headlines On Deadline ...