September 2008
Cover Story
Predictive modeling programs are ready for prime time. David Eddy describes Archimedes and what it can do for insurers, patients, and doctors.
With Congress engineering big changes, plans are likely to face cuts unless legislators take a new approach to fixing the physician pay formula
References to maximum allowable prices in contracts between plans and PBMs need to be scrutinized, since things are not always what they seem
The Medicare Payment Advisory Commission is asking Congress to promote primary care and to hold providers accountable
Patient satisfaction remains an important characteristic of a health plan, particularly at open enrollment time. WilsonRx’s annual survey tells the tale.
Editor’s Memo
Legislation & Regulation
Their argument in California is that insurers should spend a minimum of 85 percent of their revenue on services
Medication Management
A low return on investment and high implementation costs keep dose optimization from taking hold in some pharmacy benefit programs
Compensation Monitor
The Formulary Files
Plan Watch
Blue Cross Blue Shield of Michigan makes it easier for oncologists to get information that will help them improve quality, cut costs
Tomorrow’s Medicine
A common gripe with oral anesthetics is the amount of time it takes for them to wear off
Managed Care Outlook
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