Clinical executives at health plans want to see how providers react to draft recommendation against procedure
Discrimination persists in many areas, but slow progress is being made
The size of the essential benefits package may determine whether insurers can operate in the highly regulated exchange market. Expect strong lobbying from health care interest groups.
Determining return on investment and improvement of outcomes is essential when new programs are being tried, but the research method must be chosen carefully
With national attention on health care reform and new models of care, the NCQA’s VP for performance measurement looks at how quality improvement can stay at the forefront
LEGISLATION & REGULATION
The gray market, where medications can be repriced, is becoming unmanageable
MANAGED CARE OUTLOOK
Lipitor led the way, and other blockbusters are following
Decision support tools provide new options for oncologists and health plans
Holding physicians to best-practice guidelines with the threat of refusing to pay for unnecessary tests reaps dividends
Managed care once again faces the all-too-familiar debate about cost and benefit
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.