July 2008

Cover Story

Many Changes in Store As Physicians Become Employees
As doctors increasingly go to work for hospital systems, care might become more organized and effective, but plans could lose bargaining power

Lola Butcher

Payers Struggle to Ensure High Level of Adherence to Costly Specialty Drugs
Use of aggressive techniques to encourage patient adherence saves and improves lives and controls costs

Martin Sipkoff

Future Shock for Insurers
The Genetic Information Nondiscrimination Act will have a profound effect on insurers, even if we’re not quite sure what it will be

John Carroll

How Long Is Too Long?
Leapfrog’s revised length-of-stay measure is an early and welcome attempt to measure hospitals’ efficiency

Tom Reinke

Bring ‘Young Invincibles’ Into the System
Anthem Blue Cross & Blue Shield bets that focusing on this portion of the individual market might be a good way to build brand loyalty

Frank Diamond

Editor’s Memo

Health Care Consumers Really Are Sensitive to Prices

John Marcille

Viewpoint

Administrative Burdens Make Medicare Part D Cumbersome
Initially, Part D offered so much to so many who needed help. Now the program is straining under its own weight.

Tom Kaye, RPh, MBA

Legislation & Regulation

Microsoft & Google PHRs Draw Government Interest
These giant Internet players can offer the fluidity of personal data and information, but they don’t have to comply with privacy standards

John Carroll

Medication Management

How Do Employers Cut Rx Costs? Let Us Count the Ways
Employers have implemented a number of methods to slow down prescription drug costs, but waiving copayments for chronic conditions has yet to enjoy widespread use

Martin Sipkoff

Compensation Monitor

Medicare enrollees oppose cuts to MA to fix physician pay
The Formulary Files

Third antidepressant tier requires careful design
Tomorrow’s Medicine

Alvimopan Hastens Recovery From Abdominal Surgery
Commercial and public payers concerned by prolonged hospital stays will be considering this μ-opioid antagonist

Thomas Morrow, MD

Plan Watch

High Hospital Capacity Raises Quality Concerns
Health plans should look into why medical centers that spend the most per capita don’t necessarily deliver the best care

Frank Diamond

Managed Care Outlook

Employers offer incentives to better health



News & Commentary

Statin Spending Up 156 Percent

Workplace Wellness Programs Proliferate

Insurance Connector Key To Newly Proposed Health Plan

Flat growth in medical costs in 2009

Headlines On Deadline …