Managed Care
Disease
Management

 

July 2013

A partnership with a respected hospital system or large physician practice could increase a health plan’s market share

Thomas Reinke

As the ACA brings access to insurance, it could trigger consideration of price controls for providers and manufacturers

Payers may rejoice at learning that at long last, the general public is being warned about overtesting and overtreating

Tom Emerick ; Al Lewis

Collaboration is the name of the game these days, but even when lower-level providers speak up, will physicians really listen?

Frank Diamond

Despite their attraction, these cost-control programs don’t always deliver

Tom McCann

For centuries, the problem in medicine was too little information. Now there’s too much, and doctors need help coping.

Barry Patel, PharmD
Although this practice can optimize long-term patient outcomes, it is not routine in clinical practice
Kathryn S. Kolibaba, MD



Departments
Medication Management

With limited peer-reviewed literature, health plans take an evaluative approach to tumor profile testing

Thomas Reinke
Legislation & Regulation

At issue is how much large provider systems can charge for services after they’ve acquired physician practices

John Carroll
The Wider View

The country’s catastrophic economic situation shrinks coverage, closes hospitals, and cuts physicians’ salaries — and that might be just the beginning

Robert Royce, PhD
Plan Watch

The insurer hopes to give businesses of between 50 and 400 employees more flexibility under defined contribution

Frank Diamond
Tomorrow’s Medicine

This new treatment for nephritic cystinosis costs a quarter million annually, whereas the original formulation comes in at $8,000

Thomas Morrow, MD