April 2010

Cover Story

Some Plans May Prosper Despite Medicare Advantage Cuts
It depends partly on whether the population is rural or urban and whether utilization can be controlled

John Carroll

Q&A: A Conversation with Steffie J. Woolhandler, MD, MPH

Despite the Reform Law, Don’t Write Off Single Payer
A longtime advocate is still betting on a single payer system because, she says, the new reform law won’t come near to doing what’s needed

New Drugs Continue to Lack Info P&T Committees Need
When many randomized trials are badly done or irrelevant, what are formulary managers and committees to do?

Ed Silverman

Young Docs Not Confident They Have Business Sense
When physicians lack sufficient preparation, they are frustrated, and their relationships with insurers can suffer

Frank Diamond

Medicare Gets Serious About Payment Cuts
Multiple cost cutting strategies zero in on every aspect of physician remuneration

Thomas Reinke

Lessons from European Models for Universal Coverage
Risk adjustment is part of the reform package, but other countries have had problems with implementation

Richard Mark Kirkner

Editor’s Memo

Sorting It Out Won’t Be Easy, Now That the Deed Is Done

John Marcille

Viewpoint

Insurers Should Back Programs To Make Patients Responsible
A physician argues that the health care system cannot be truly reformed unless enrollees open their eyes to the facts of healthy living

Gail J. Dudley, DO

Legislation & Regulation

Look for State Prosecutors To Enforce Data Privacy Rules
HIPAA was all bark when it came to penalties for failing to protect personal health and financial records. HITECH is already showing some bite.

John Carroll

Medication Management

Drug-Induced Diseases Focus of Pharmacy Manual
Sometimes the cure can pose the biggest threat, the data suggest

Martin Sipkoff

Compensation Monitor

Imbalances seen with revenues, compensation
The Formulary Files

More patients leaving Rxs at the pharmacy counter
Plan Watch

Can Defined Contribution Rescue Retiree Coverage?
UnitedHealthcare and Towers Watson team up to capture the business of employers who provide coverage for former employees

Frank Diamond

Tomorrow’s Medicine

FDA Panel Likes New Treatment for Idiopathic Pulmonary Fibrosis
A fatal disease with many victims, IPF has been shown to progress more slowly when treated by pirfenidone. The FDA itself has not yet ruled on it.

Thomas Morrow, MD

Managed Care Outlook

Drug prices on the rise as coverage gap looms



News & Commentary

Health Care Costs Burden Families More

GAO Studies E-Health Exchange

Study: Warfarin Genotyping Reduces Hospitalization Rates

Headlines On Deadline...

Enrollment in managed care Medicaid at highest level