Managed Care



May 2014

Hospitals are hyping better outcomes with the robot, but economics and marketing may be driving the push

Richard Mark Kirkner

Payers attracted by the siren song of this cost-cutting strategy don’t always appreciate its risks and complications

Peter Boland, PhD ; David Gibson, MD

Fine tuning, not abandoning PSA testing, is the approach

Thomas Reinke

Humana CMO looks to Medicare Advantage and quality scores to drive the company toward new relationships with members, providers, and the government

John Marcille

An instance where the ubiquitous “more research is needed” very much sums up the debate

Frank Diamond

Legislation & Regulation

Estimates for Sovaldi place it in an expensive neighborhood for medications, but the virus it fights moves slowly

John Carroll
Medication Management

There’s still no “magic pill,” but new medications abound. With the disease uncontrolled in millions, it’s time to get utilization management just right.

Thomas Reinke
The Formulary Files
Michael D. Dalzell
Plan Watch

Kaiser Permanente patients who feel that they are part of the care decision process are more likely to stay on antidepressants

Frank Diamond
Tomorrow's Medicine

Otezla (apremilast) sparks hope about treatment, but also concern about depression and suicidal thoughts

Thomas Morrow, MD


4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium 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
HealthIMPACT Southeast Tampa, FL January 23, 2015