November 2008

Will Biomarkers Bring Smarter Care?
Expanded blood testing can reveal much about individuals’ health risks, but how should health plans decide on coverage?

Steven R. Peskin, MD, MBA

Plans Slow to Cover At-Home BP Monitoring
Because readings in the clinic are unreliable and are a questionable guide to diagnosing and treating high blood pressure, self-monitoring deserves a look

Lola Butcher

Is Care Coordination Making Carve-outs Less Desirable?
Health plans are evaluating whether to stop carving out drug benefits, disease management, and even behavioral health management

Martin Sipkoff

Letters to the Editor

Oncologists Plead For Fairer Drug Payments
Once accused of milking the system, oncologists are now complaining that they are losing money on some drugs that they administer

John Carroll

Keep Employers In a Primary Role: A Conversation With Martin Sepulveda, MD
The man credited with health care innovation at IBM warns against any overhaul that would make companies disinclined to participate
Tomorrow’s Medicine

Gene Therapy Offers HD Patients Relief From Some Symptoms
Tetrabenazine inhibits the transport of a molecule called vesicular monoamine transporter type 2 or VMAT2

Thomas Morrow, MD

Compensation Monitor

Is managed care losing its coercive power?
Editor’s Memo

Health Plans Should Try To Feel Physicians’ Pain

John Marcille

The Formulary Files

Use of multitier benefit designs increases
Medication Management

Pharmacists Can Be Crucial To Medical Home
The increasing use of electronic records may lead the way toward access to diagnostic rationales and long-range patient treatment histories

Martin Sipkoff

Managed Care Outlook

Fewer Part D options for low-income seniors
Plan Watch

Molina Program Addresses Racial Disparity in Detroit
Molina Healthcare of Michigan leans on education in effort to improve care for black men

Frank Diamond

Legislation & Regulation

Mental Health Parity Leaves a Lot Out
Though the legislation isn’t comprehensive and won’t be a burden, some health plans will need to scramble to build specialist provider networks

John Carroll



News & Commentary

PCPs report little knowledge of CDHPs

Headlines On Deadline…

Uninsured Don’t Jam Up the ED

Spending on Medicaid Outpaces Economic Growth

‘Michelle’s Law’ Mandates Coverage