Biologics Debate Heats Up Between FDA, NCCN

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September 2011Is the breast cancer drug Avastin the opening salvo that brings efficacy, toxicity, and costs together? Who will blink first — health plans, providers, regulators, or patients?
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TOMORROW’S MEDICINE

Injected Device Shown Effective in Reducing Fecal Incontinence
For this condition that is largely confined to the Medicare population, a new treatment is now available
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NEWS & COMMENTARY

How much do private insurers pay for outpatient mental health services?
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LEGISLATION & REGULATION

Tougher CMS Readmissions Rules Afflict Hospitals at a Bad Time
In the long run, health plans will benefit from the new rules. In the short run, hospitals say they already have enough economic pressures.
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NEWS & COMMENTARY

Group Wants More Imaging for Stroke
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MEDICATION MANAGEMENT

Plans and Oncologists Don’t See Eye to Eye on Prior Authorization
Expect more denials as more specialty drugs are introduced and prescribed
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Q&A

A Conversation with David Nace, MD: Primary Care Stakes a Big Tent
As the medical home concept grows, many in health care will have to define new roles
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NEWS & COMMENTARY

U.S. Docs Outspend Ontario Physicians
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FORMULARY FILES

Drug tier coverage differs by plan type
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MANAGED CARE OUTLOOK

Health plan enrollment to grow 2 percent by 2014
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PEER-REVIEWED

Meeting the Challenges and Burdens Associated With Hereditary Angioedema
With the advent of new disease-specific agents, some patients with HAE may find relief from its enormous physical and psychological toll
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NEWS & COMMENTARY

As CDHPs Grow More Prevalent, Savings Will Probably Decline
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COMPENSATION MONITOR

Plastic surgeons ask: What recession?
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EDITOR’S MEMO

Managed Care Industry Change Looks to Outcomes, Not Process
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Heart Failure Treatment Gaps Costs Lives, Hikes Expenses
Health insurance plans need only bolster the following accepted guidelines to see a return on a very little bit of investment
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NEWS & COMMENTARY

Headlines On Deadline
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COVER STORY

At Long Last… Pay for Outcomes Starts to Replace Pay for Performance
Think of P4O as P4P with its eyes on the prize. Unfortunately, even ordinary P4P is not yet widespread.
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