Physicians are fairly ignorant of what consumer-directed health care will mean to them in terms of relations with patients and health plans
Insurers need a coverage strategy that focuses on reducing post-surgical complications and avoiding adverse selection
Urged on by employers traumatized by costs, health plans are renewing their interest in prior authorization, but using a lighter hand
The health care economist says that consumers ought to share in the savings from making the right choices. Insurers, providers, and hospitals should make sure that options exist.
Aetna incorporates a program developed at the University of Pennsylvania to deliver services where members live
Legislation & Regulation
Recent court ruling means that beneficiaries should be notified about insurers' decision-making powers
Changes in reimbursement patterns for obesity drugs will take several years. Lifestyle changes remain the first approach.
The Formulary Files
Should a new (and cheap) test for chronic lymphocytic leukemia be a component of prior-authorization protocols?