IN THIS ISSUE

The ACA drove down the uninsured rate despite the lack of Medicaid expansion, but major insurers have left the market. In some rural areas, Florida Blue is the only insurer in the individual market.
Conservatives say Tennessee’s experience shows the ACA’s fatal weaknesses. But one expert believes that, properly nurtured, the state’s individual market could thrive.
Put the emphasis on ‘slowly.’ Still, those who make policy and those who sell policies will take any sign of hope they can get.
The Bay State can boast of the lowest uninsured rate, but the high costs give even proponents pause.
Joseph Burns
Maine has a rich history of health care policy innovation, although it was the ACA that finally brought down the uninsured rate. An older, rural population means no guarantees.
The Democratic governor and the Republican legislature have moved to shore up the individual market, but Minnesotans are leaving it in droves.
Managing Editor’s Memo
Frank Diamond
Legislation & Regulation
Richard Mark Kirkner
Managed Care Editors

Kevin Kuhlman, NFIB

Expected executive order would expand definition
Medication Management
Thomas Reinke

William Chavey, MD
University of Michigan

Price and physician reluctance to swap it into complicated regimens for heart failure could explain tepid sales.
Value-Based Tools

Robert Pendleton, MD
University of Utah Health Care

University of Utah’s Value-Driven Outcomes program encourages attention to process. It’s a maligned concept in health care quality these days, but one Utah has refined to drive better outcomes.
Tomorrow's Medicine
It produces better outcomes, is easier to administer, and costs less than competing drugs. Nothing’s perfect, but this could be the beginning of a better era for payers.
News & Commentary
News & Commentary