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March 2011

Features

Cover Story

The Business Case for Process Improvement
3 Success Stories
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Can Arthroplasty’s Costs Be Contained?
Try ‘bundled payments, accountability, and consumer involvement,’ one surgeon advises
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Stressed States Open Doors to Medicaid Managed Care
Plans are increasingly trusted with management of the ABDs — aged, blind, and disabled
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US Family Health Plan Satisfies Members in Many Ways
The managed care network shares new ideas about increasing patient satisfaction, reducing hospital admissions, and producing better outcomes overall
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Home Is Where the Care Is?
Evidence suggests that a select group of patients could be better managed outside the costly hospital
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Formulary Management

Part D Model Guidelines Updated Far Too Infrequently
The static approach overseen by United States Pharmacopoeia shortchanges beneficiaries and benefit plans
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Departments

Editor’s Memo

Never Being Satisfied Part of Job Description
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Legislation & Regulation

States May Yet Regret Their Many Mandates
Health plans that have resisted inappropriate state mandates might be in a position to bill those states for their cost when policies are sold through an exchange
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Medication Management

Stakeholders Say FDA Must Change REMS Program
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Compensation Monitor

Productivity continues to outpace compensation
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The Formulary Files

More PBMs used for dispensing, utilization review
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Plan Watch

Opportunity Weighed in Quit-Smoking Effort
Blue Cross & Blue Shield of Minnesota hopes that adding weight maintenance to its tobacco program will bolster results
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Tomorrow’s Medicine

Is This the End of Painful Injections?
Using microneedle technology to deliver drugs avoids many of the pitfalls of the traditional needle-and-syringe mechanism
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Managed Care Outlook

Use of TNF inhibitors for RA to fall sharply
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News

Antibiotic Limits Result in Savings    DIGITAL | HTML

Growing MA Membership Requires More Provider/Network Oversight    DIGITAL | HTML

Headlines On Deadline    DIGITAL | HTML

PBM rebate arrangements    DIGITAL | HTML