2017 Editorial Calendar

January	Measurement and rating An in-depth look at quality measurement of providers and health plans Also: Spotlight on real-world evidence
February	Sexual health STDs, coverage of treatment of erectile dysfunction, and other issues at the crossroad of sexual health and managed care
March	Biosimilars Also: Update on generics
April	Telemedicine
May	Cancer Also: Spotlight on real-world evidence in oncology based on news from AACR and in the lead up to ASCO.
June	Niche diseases and specialty medications
July	General interest
August	The 10 Most Important People in Managed Care — and other lists
September	How Doctors Are Paid Now, And Why It Has to Change
October	Autoimmune diseases
November	Medical directors and chief medical officers
December	Our 3rd Annual YIP (Year in Preview) issue

Well, they’ve defied expectations so far. It was expected that MA enrollment would decline from 10.9 million enrollees (or 24% of all Medicare enrollment) to 8.2 million (15% of Medicare’s total enrollment). Instead, enrollment has continued to climb. In 2016, 17.6 million Medicare beneficiaries—or 31% of all beneficiaries—were in MA plans.

The Missing Ingredient In Quality Measurement

The measures most often used today to assess care quality are process measures. Actual outcomes, of course, are harder to measure than whether a certain action has been taken—checking the feet of a patient with diabetes, for example. But many experts don’t think process measures get at the heart of quality.

HEDIS Is the Hassle That Became a Habit

After 25 years, the Healthcare Effectiveness Data and Information Set (HEDIS) is still criticized for focusing on process and taking up doctors’ time. But it has been incorporated into physicians’ workflow and may yet be instrumental in bringing about value-based care.

“Top 15” List Predicts Best-Selling Cancer Drugs in 2022

FiercePharma has compiled a list of the top 15 cancer medications that are expected to dominate the oncology market in 2022.

The reviews are in! CMS Rating of Hospitals Gets 1.5 Stars

The problem, say hospitals and some analysts, is that rating hospital quality is not so straightforward. How a hospital delivers care is multifactorial and complex, they argue, so trying to cram that into a single score is misleading and can end up like rating a restaurant on its parking.

Is Step Therapy a Move In the Wrong Direction?

If insurers insist that doctors use older, lower-cost drugs first, the burden is on the health plan to respond to doctors’ request for different medications quickly, nimbly, and appropriately. But quick and nimble do not often describe insurers’ step-therapy efforts.

Joint Venture Health Plans May Give ACOs a Run for Their Money

Joint venture plans are starting to demonstrate their ability to implement clinical management and financial management reforms. A JV health plan replaces the offloading of financial risk by health plans to ill-equipped providers with an executive-level cost management committee stated jointly by the hospital and payer.

Integrated Plans Fertile for Real-world Evidence

But most insurers are taking a wait-and-see attitude even though in some clinical areas, such as diabetes, real-world evidence (RWE) has been a true game-changer. Payers have a pessimistic view that RWE can help them. It doesn’t help that respected voices in health care agree.

For ED, the Doctor Is in But the Men Are Staying Away

Men’s health care changed dramatically after the FDA approved Pfizer’s blue, diamond-shaped Viagra. Suddenly men were interested in seeing their doctors if for only one reason. Now, with restrictions on what some call a lifestyle drug, other health problems go uncharted.

Fake Doctor Roams Boston Hospital

For several days, a middle-aged woman who claimed to be a doctor in training roamed the halls of Brigham and Women’s Hospital in Boston, dressed in scrubs, asking questions at a lecture, attending patient rounds, and observing surgical procedures, according to a report in the Boston Globe

Paul Lendner

Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweißen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.

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