June 2011

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Features

COVER STORY

Onerous Regulations Put ACOs on Ropes
Health insurers can be doing more to come up with creative ways to pay providers and organize care
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Payers Step in With ‘Real-World’ Comparative Effectiveness Research
With access to large patient populations, health plans are in a position to mine a fresh set of data, but concerns about bias remain
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Q&A

A Conversation With Michael Kanter, MD: Casting a Wider Net
Kaiser Permanente takes on patient safety initiatives in the outpatient setting
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Pursuing a Bang for the Buck In the Battle of the Bulge
For health plans and employer groups, the economics of battling obesity are not always obvious
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Plans Breathe Life Into COPD Efforts
The disease has risen quickly to become the third-leading cause of death in the world — getting there much faster than anyone expected
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PEER-REVIEWED

Health Care Costs Associated With Treatment Modification in Type 2 Diabetes Mellitus Patients Taking Oral Anti-diabetic Drugs
A comparison of health care costs in patients with diabetes who do not initially respond to oral therapy suggests that it might be appropriate and clinically beneficial for providers to consider adding another oral agent, rather than up-titrating the current medication, particularly beyond intermediate dose levels
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Departments

EDITOR’S MEMO

Did Push for ACOs Ignore Basic Math?
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LEGISLATION & REGULATION

IPAB Likely to Put Pressure On Medicare Advantage and Part D
The Independent Payment Advisory Board, created by the Affordable Care Act, favors hospitals over health plans
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MEDICATION MANAGEMENT

E-Prescribing Grows Quickly, Suffers From Data Problems
Health plans play a key role in data quality and will benefit from improvements
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COMPENSATION MONITOR

Pharmacists test payment model based on outcomes
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THE FORMULARY FILES

Government payers shouldering more Rx payments
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PLAN WATCH

PBM Effort Takes Cue From Reform, Market
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TOMORROW’S MEDICINE

New Prostate Cancer Drug Encourages Development of Treatment Pathway
With Zytiga joining the ranks, managed care may have a way to develop an oncology strategy for a common type of cancer
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MANAGED CARE OUTLOOK

Medical cost trend for 2012 to hit 8.5 percent
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News

600K Young Adults Benefit From ACA    DIGITAL | HTML

Cancer Drug Category Facing 34% to 42% Growth    DIGITAL | HTML

Headlines On Deadline    DIGITAL | HTML

More Primary Care, Lower Death Rate    DIGITAL | HTML

Slower rates for health care costs reported by Standard and Poor’s    DIGITAL | HTML