Managed Care

Managing Editor’s Memo
Frank Diamond
It’s not a boxing opponent. But the metaphor of “the fight” clings more closely to cancer than to other diseases. And while attitude does, indeed, count when it comes to handling any ailment, positive and optimistic people die from cancer every day. Meanwhile, some grumps go on. It’s a disease.…
Editor’s Memo
Peter Wehrwein
This issue of Managed Care was billed as being about Medicaid managed care and vulnerable populations. But as grumpy editors often say, that’s a topic not a story. And it didn’t take us very long to discover that the story was social determinants of health. Lola Butcher, a regular contributor to…
Managing Editor’s Memo
Frank Diamond
The sitcom created by Chris Rock, Everybody Hates Chris, which ran from 2005 until 2009, conjured laughs out of the everyday. One bit I particularly relish is when the narrator (the persona of Rock as a teenager) says that his father was like Rain Man when it came to knowing what everything costs. “That’s…
Howard Wolinsky
Venture philanthropy and the move toward investment of not-for-profit dollars in for-profit companies started about 10 years ago. One expert argues that it’s a little like calling someone an amateur-pro athlete. You can’t be both. Proponents, however, point to some initially impressive results especially for niche diseases.
Managed Care Outlook
Coronary heart disease deaths will decline by 30% between 2010 and 2020 because of improvement in “cardiovascular health metrics” (avoidance of smoking, more physical activity, and so on). But this less-deadly era of CVD is going to be a more costly one, with direct medical costs more than doubling by 2030 to $918 billion from $396 billion in 2012.
Sexual Health
Susan Ladika
Not too long ago, rates for sexually transmitted diseases (STDs) in the United States were at historic lows. Now they are at record highs, and many experts fear they will continue to climb because of meager funding of public health clinics and diminished sex education in schools.
Thomas Reinke

Beth Ginzinger
Anthem

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.

What To Expect in 2017: Managed Care Year in Preview
Susan Ladika
Health care ranked ninth in terms of its cybersecurity in a recent report by SecurityScorecard, a company that provides risk monitoring and security ratings. The health care industry is widely infected with malware and has come under repeated ransomware attacks.