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October 2011

VBID is a promising approach to improving health and cost outcomes, but its use has been limited. Expanding it to complicated interventions will require a lot of effort.
Michael D. Dalzell
The National Business Group on Health’s CEO looks for employers and insurers to collaborate to improve patient safety and cut costs
John Marcille
Once in a while something comes up that requires the sort of immediate and intense intervention that’s downright heroic
Frank Diamond
Lax regulations and fee-for-service payment make an irresistible mix for physician conflicts. Are ACOs the answer?
Richard Mark Kirkner
Medco’s ‘gaps in care’ approach saves $900 million by targeting 15 chronic conditions
Carol Milano
This is no one-size-fits-all solution, as insurers across the country tailor efforts for specific markets
Lola Butcher
A widely available but underused molecular genetic blood test has proved to be accurate over 98% of the time and costs less than $400
Michael Graf, MS



Departments
Editor's Memo
John Marcille
Viewpoint
In a system where people will soon shop for their benefits on exchanges, plans that offer the best customer service will have the edge
Jeff Kang, MD
Medication Management
Health plans are expanding MTM — once considered a Part D mainstay — to their commercial businesses.
Thomas Reinke
Evidence Review
A summary of the ECRI Institute’s Emerging Technology Evidence Report
Legislation & Regulation
The need for health plans to cut administrative costs is hammering insurance brokers. Is this another instance of the law of unintended consequences?
John Carroll
Tomorrow’s Medicine
Brilinta’s price will be a significant factor in coverage decisions when Plavix goes off patent in May 2012
Thomas Morrow, MD
Plan Watch
If UnitedHealth Group’s effort to buy a large physician group proves successful, clinical execs will have even more oversight
Frank Diamond