Most popular articles on this site Articles on pharmacy Articles on capitation Articles on disease management

www managedcaremag.com

Peer-reviewed studies

Scientific studies relating to the cost and effectiveness of programs, products, and procedures in health care financing and delivery. Newest articles are listed first. To submit an article for publication in Managed Care magazine, see the Call for Papers.

Loss of Confidence in Diabetes Management



Patricia R. Salber, MD, MBA, William Bestermann, MD, Stanley Schwartz MD, Albert Marchetti, MD

ABSTRACT | PDF

Evaluation of a Continuous Glucose Monitoring System for Home-Use Conditions



Bruce Bode, MD, Michael Silver, MD, Richard Weiss, MS, Kathryn Martin, PharmD

ABSTRACT | PDF

Health Plan Joins With Physical Therapy Facility to Manage Back and Neck Pain


Capital Health Plan achieved a 79% improvement in pain scores and a 54% improvement in function scores for its members
Charles M. Tomlinson, MD, Chad Gray, PT, Tom Kane, PT

ABSTRACT | PDF

Using Option-Based Contracts to Improve Health Outcomes


A system in which individual insurance policies may be purchased for separate medical products and services is based on a medical options market and takes its cue from the financial sector
Damon Douglas, dual PharmD/MBA candidate

ABSTRACT | PDF

In Chronic Disease, Nationwide Data Show Poor Adherence by Patients to Medication and by Physicians to Guidelines


A widespread approach that incorporates various stakeholders may be necessary to change adherence behavior
Sara L. Thier, MPH, Kristina S. Yu-Isenberg, PhD, MPH, RPh, Brian F. Leas, MS, MA, C. Ron Cantrell, PhD, Sandra DeBussey, Neil I. Goldfarb

ABSTRACT | PDF

Optimizing the Use of 17P In Pregnant Managed Medicaid Members



Mary V. Mason, MD, MBA, Kara M. House, MBA, Janice Linehan, PA-C, MHP, Carol A. Speers, RN, Lisa M. Joseph, RN, MBA, Ray Littlejohn

ABSTRACT | PDF

Evolution of TennCare Yields Valuable Lessons


The old TennCare program had many flaws and detractors. Its near collapse led to a more realistic approach to providing coverage to the uninsured in Tennessee.
Cyril F. Chang, PhD

ABSTRACT | PDF

Comparison of Human Growth Hormone Products' Cost in Pediatric and Adult Patients


Payers' drug costs for human growth hormone are related to product waste that is related to the container in which the product is supplied
Gary R. Bazalo, MS, Ashish V. Joshi, PhD, John Germak, MD

ABSTRACT | PDF

Determining the Cost-Effectiveness of a Computer-Based Smoking Cessation Intervention in Primary Care



Meredith Y. Smith, PhD, Purdue Pharma, Stamford, Conn., Jerry Cromwell, PhD, Research Triangle Institute, Research Triangle Park, N.C., Judith DePue, EdD, Miriam Hospital/Brown Medical School, Providence, R.I., Bonnie Spring, PhD, Northwestern University, Chicago, Ill., William Redd, PhD, Mount Sinai School of Medicine, New York, N.Y., Marina Unrod, PhD, Mount Sinai School of Medicine, New York, N.Y.

ABSTRACT | PDF

The Appropriate Omalizumab Patient


Management of the uncontrolled asthma patient and case examples
Jill Karpel, MD, Donald A. Bukstein, MD, Robert LoNigro

ABSTRACT | PDF

Applying the Planned Care Model To Intimate Partner Violence


Implementing what was formerly called the Chronic Care Model can improve an organization's response to this widespread problem
Therese Zink, MD, MPH, Karen Lloyd, PhD, LP, George Isham, MD, David J. Mathews, PsyD, LICSW, Terry Crowson, MD

ABSTRACT | PDF

The Use of Therapeutic Interchange For Biologic Therapies



Joseph Flood, MD, FACR, Charles Mihalik, PharmD, RPh, Renee R. Fleming, RPh, MBA, Bruce E. Strober, MD, PhD, Deborah R. Zucker, MD, PhD, Douglas S. Burgoyne, PharmD, RPh

ABSTRACT | PDF

Implementing Disease Management Programs for Type 2 Diabetes in Germany


Germany has been able to enroll more than a million people with type 2 diabetes in DM programs through legislation that created incentives for physicians and insurers
Heinz Nagel, MD, Thomas Baehring, PhD, Werner A. Scherbaum, MD, PhD

ABSTRACT | PDF

Compliance With Antithrombotic Guidelines: Current Practice, Barriers, and Strategies For Improvement


Deeply held, but not evidence-based, concerns about the possible risks of pharmacologic prophylaxis leave many patients at risk for DVT
Joseph A. Caprini, MD, Thomas M. Hyers, MD, FCCP

ABSTRACT | PDF

When Overcrowding Paralyzes an Emergency Department


Changing the process and mindset of health care professionals was the key to reducing emergency department overcrowding
Joseph R. Twanmoh, MD, FACEP, Gail P. Cunningham, MD, FACEP

ABSTRACT | PDF

The Cost-Effectiveness of Omega-3 Supplements For Prevention of Secondary Coronary Events


Dietary supplementation with omega-3 fatty acids in U.S. males is associated with fewer cardiovascular fatalities and lower costs
Jordana K. Schmier, MA, Nancy J. Rachman, PhD, Michael T. Halpern, MD, PhD

ABSTRACT | PDF

The Cost Benefit to Health Plans of Pharmacotherapy for Alzheimer's Disease


As with other chronic diseases of aging, early diagnosis and pharmacologic therapy may reduce the costs for enrollees with Alzheimer's disease
David S. Geldmacher, MD

ABSTRACT | PDF

17 Alpha-Hydroxyprogesterone Caproate (17P) Usage in a Medicaid Managed Care Plan and Reduction in Neonatal Intensive Care Unit Days


Offering 17P as a benefit to pregnant women enrollees with a history of preterm delivery can reduce NICU days significantly for a Medicaid plan.
Mary V. Mason, MD, MBA, Kara M. House, BS, MBA, Cathy M. Fuest, RPh, Deborah R. Fitzgerald, RN, Bonnie J. Kitson, MBA, Jacqueline A. Inglis, RN, BSN, MM

ABSTRACT | PDF

Evaluating the Nondrug Costs of Formulary Coverage Restrictions


Substantial nondrug costs result from switching prescribed medications in response to changes in insurance coverage, and many nonreimbursed costs shift to providers and patients.
Paul Abourjaily, PharmD, William A. Gouveia, MS, Harry P. Selker, MD, MSPH, Deborah R. Zucker, MD, PhD

ABSTRACT | PDF

Consumer-Directed Health Plans: Enrollee Views, Early Employer Experience


As CDHPs increasingly penetrate the commercial market , their greatest contribution might lie in funding health services for retirees and in reducing the number of uninsured people by offering affordable insurance.
Janice Frates, PhD, Ellen Severoni, RN

ABSTRACT | PDF

Clinical and Economic Effects of Coronary Restenosis After Percutaneous Coronary Intervention in a Managed Care Population


This study is the first to estimate costs and medical resource use associated with restenosis involving bare metal stents in managed care percutaneous coronary intervention patients.
Mary Ann Clark, MHA, Ameet Bakhai, MD, Elise M. Pelletier, MS, David J. Cohen, MD, MSc

ABSTRACT | PDF

Managing Drugs for Rare Genetic Diseases: Trends and Insights


This article evaluates recent trends and challenges in health system management of exceedingly rare genetic diseases, from the perspective of the manufacturer, managed care organization, physician, and actuary.
Mark Zitter, MBA

ABSTRACT | PDF

Measuring Outpatient Outcomes of Emesis and Nausea Management in Pregnant Women


In this study, outpatient management was effective in controlling nausea and vomiting during pregnancy and was associated with a reduced need for hospital or emergency room treatment as well as reduced costs.
David G. Lombardi, MD, Niki B. Istwan, RN, Debbie J. Rhea, MPH, John M. O'Brien, MD, John R. Barton, MD

ABSTRACT | PDF

Evaluating New Therapies for Psoriasis



Thomas Morrow, MD

ABSTRACT | PDF

Cost-effective Management of Hyperglycemia in Patients With Type 2 Diabetes Using Oral Agents



Udaya M. Kabadi, MD

ABSTRACT | PDF

Advances in Migraine Management: Implications for Managed Care Organizations



David W. Dodick, MD, Robert J. Lipsy, PharmD

ABSTRACT | PDF

IgE-Blocking Therapy for Difficult-to-Treat Asthma: A Brief Review



Gailen D. Marshall Jr., MD, PhD, Christine A. Sorkness, PharmD

ABSTRACT | PDF

Improving Oral Pharmacologic Treatment And Management of Type 2 Diabetes



George E. Dailey III, MD

ABSTRACT | PDF

Treating Psoriasis Patients With Biologic Agents



David M. Pariser, MD, Jeffrey Lenow, MD, JD

ABSTRACT | PDF

Case Study of a Failed Merger of Hospital Systems



Jaan Sidorov, MD

ABSTRACT | PDF

Balancing the Health Care Scorecard



Judith A. Shutt

ABSTRACT | PDF

Managing Perinatal Outcomes: The Clinical Benefit and Cost-Effectiveness of Pharmacologic Treatment of Recurrent Preterm Labor



Fung Lam, MD, Niki B. Istwan, RN, BS, Debbie Jacques, MPH, Suzanne K. Coleman, RNC, MS, Gary J. Stanziano, MD

ABSTRACT | PDF

A Health Care Management Company's Experience With Palivizumab -- 1 Year Later



William Silverman, MD, FAAP

ABSTRACT | PDF

Management of Moderate to Severe Plaque Psoriasis with Biologic Therapy



David M. Pariser, MD

ABSTRACT | PDF

Economic Analysis of Oral and Topical Therapies for Onychomycosis of the the Toenails and Fingernails



Julian Casciano, Karine Amaya, PhD, John Doyle, MPH, Steve Arikian, MD, Neil Shear, MD, Marc Haspel, DPM

ABSTRACT | PDF

The Quandary of Compounding for MCOs: Administrative Costs, Risks, and Waste



Thomas Kaye, RPh, MBA

ABSTRACT | PDF

Measuring Efficiency of Physician Practices Using Data Envelopment Analysis



Steven Andes, PhD, CPA, Lawrence M. Metzger, PhD, CPA, John Kralewski, PhD, David Gans, MSHA

ABSTRACT | PDF

Is 34 Weeks an Acceptable Goal For a Complicated Singleton Pregnancy?



J. Stephen Jones, MD

ABSTRACT | PDF

Examining Costs of Chronic Conditions In a Medicaid Population



Robert I. Garis, RPh, PhD, Kevin C. Farmer, PhD

ABSTRACT | PDF

Diabetes Disease Management in a Community-Based Setting



Gregory D. Berg, PhD, Sandeep Wadhwa, MD, MBA

ABSTRACT | PDF

Estimating Pediatric Primary Care Provider Visits In a Capitated Environment: Encounter vs. Claims Databases



Ernest P. Schloss

ABSTRACT | PDF

The Effect of Practitioner Compensation on HMO Consumer Satisfaction



John F. Scoggins, PhD

ABSTRACT | PDF

An In-Office Diagnostic Procedure To Detect Dermatophytes In a Nationwide Study of Onychomycosis Patients



David Pariser, MD, Carol Opper

ABSTRACT | PDF

Reframing the Pharmaceutical Manufacturer/Health Plan Relationship in Managed Care



Ira Studin, PhD, MPH

ABSTRACT | PDF

A Health Care Management Company's Experience with Palivizumab



William Silverman, MD, FAAP

ABSTRACT | PDF

Telemedicine: Cost-Effective Management of High-Risk Pregnancy



John Morrison, MD

ABSTRACT | PDF

Managed Care Trends in Statin Usage



Gary R. Bazalo, MS, MBA

ABSTRACT | PDF

Memoranda of Understanding Between Medicaid MCOs and Public Health Departments



Susan J. Zahner, DrPH, RN

ABSTRACT | PDF

Satisfaction and Patient Outcomes of a Telephone-Based Nurse Triage Service



Joan M. O'Connell, Ph.D., M.H.S., Jack L. Stanley, B.A., C. Lucy Malakar, M.A.

ABSTRACT | PDF

Inter-Rater Reliability Testing For Utilization



Sue McQuillian, FSA

ABSTRACT | PDF

A Critical Review of the Arguments for Insurance Coverage for Smoking-Cessation Therapies



Cyril F. Chang, Ph.D.

ABSTRACT | PDF

Persistence With Drug Therapy: A Practical Approach Using Administrative Claims Data



Christopher M. Dezii, R.N., M.B.A.

ABSTRACT | PDF

Medical Savings Accounts



Robert A. Connor, Ph.D., M.H.A.

ABSTRACT | PDF

An Evidence-Based Evaluation of Percutaneous Vertebroplasty



Susan A. Levine, D.V.M., Ph.D., Lawrence A. Perin, M.D., M.B.A., Diane Hayes, Ph.D., Winifred S. Hayes, Ph.D.

ABSTRACT | PDF