Managed Care

 

 

July 2012

Having driven generic utilization about as far as possible, plan sponsors are turning to a method of controlling drug costs that had all but disappeared. Aggressive contracting is driving this trend, but that may soon yield to evidence-based evaluation.

Michael D. Dalzell

Population management claims: The Seven Rules of Plausibility provide means to test the claims of population management vendors. With case studies and commentary.

Al Lewis

The CEO of StayWell Health Management discusses evolving approaches to health and wellness management under health care reform

John Marcille

Advanced therapy management may lead to physician acceptance of additional medications infused at home

Tom Reinke

This study verifies, as defined by current guidelines, that initial treatment with fixed dose combinations (FDC) is associated with a better likelihood of HbA1c goal attainment and lower health care resource use and costs.

Setareh A. Williams, PhD ; Erin K. Buysman, MS ; Erin M. Hulbert, MS ; Joette Gdovin Bergeson, PhD ; Bin Zhang, MD



Departments
Editor’s Memo
John Marcille
Viewpoint

The new schedule will burden health plans with extra costs, but will also allow a smoother transition

Ray Desrochers
Legislation & Regulation

Attempts to force hospitals to make prices public often fail for lack of standardization

John Carroll
Plan Watch

Though ROI is hard to calculate, insurer says that its on-site clinics are changing employee behavior for the good

Frank Diamond
Tomorrow’s Medicine

A tiny new implantable heart pump transmits speed, power consumption, and blood flow data directly to the cardiac center

Thomas Morrow, MD

Meetings

Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014