October 2011


A widely available but underused molecular genetic blood test has proved to be accurate over 98% of the time and costs less than $400

Michael Graf, MS


This is no one-size-fits-all solution, as insurers across the country tailor efforts for specific markets

Lola Butcher


Once in a while something comes up that requires the sort of immediate and intense intervention that’s downright heroic

Frank Diamond


Lax regulations and fee-for-service payment make an irresistible mix for physician conflicts. Are ACOs the answer?

Richard Mark Kirkner


Medco’s ‘gaps in care’ approach saves $900 million by targeting 15 chronic conditions

Carol Milano


Cover Story
VBID is a promising approach to improving health and cost outcomes, but its use has been limited. Expanding it to complicated interventions will require a lot of effort.

Michael D. Dalzell


Evidence Review
A summary of the ECRI Institute’s Emerging Technology Evidence Report


Q&A
The National Business Group on Health’s CEO looks for employers and insurers to collaborate to improve patient safety and cut costs


Editor’s Memo

John Marcille


Legislation & Regulation
The need for health plans to cut administrative costs is hammering insurance brokers. Is this another instance of the law of unintended consequences?

John Carroll


Medication Management
Health plans are expanding MTM — once considered a Part D mainstay — to their commercial businesses.

Thomas Reinke


Plan Watch
If UnitedHealth Group’s effort to buy a large physician group proves successful, clinical execs will have even more oversight

Frank Diamond


Tomorrow’s Medicine
Brilinta’s price will be a significant factor in coverage decisions when Plavix goes off patent in May 2012

Thomas Morrow, MD


Viewpoint
In a system where people will soon shop for their benefits on exchanges, plans that offer the best customer service will have the edge

Jeff Kang, MD


News and Commentary


News and Commentary


News and Commentary