January 2012

Keeping ED Costs Down an Exercise in Frustration
Visits are going up and most cases seen in the ED are legitimate. What’s a payer to do?

John Carroll


Consumer-Directed Coverage Makes Market Inroads
Those who choose these plans tend to be more educated and dedicated to maintaining healthy lifestyles

Frank Diamond


Cover Story

Decision Support’s New Advocates
Attempts to replace radiology benefit managers with a more doctor-friendly system show success

Joseph Burns


Peer-Reviewed

Treatment Persistence & Health Care Costs of Adult MDD Patients Treated With Escitalopram Vs. Citalopram in a Medicaid Population
Escitalopram patients in a Florida Medicaid population had better treatment persistence and lower total health care costs than patients prescribed citalopram

Eric Q. Wu, PhD ; Rym Ben-Hamadi, MSc ; Mei Lu, MS ; Nicolas Beaulieu, MA ; Andrew P. Yu, PhD ; M. Haim Erder, PhD


Q&A

A Conversation With F. Randy Vogenberg, PhD, RPh: Changing Market for Pharmacy Benefits
Tight budgets and an increasing influx of expensive biologic drugs make it imperative to rethink risk management

John Marcille


Compensation Monitor

Business degrees boost pay for physician executives


Managed Care Outlook

Big pharma’s struggles might benefit health plans


Plan Watch

Blues Plan Helps Practices Get Up to Speed for PCMHs
Independence Blue Cross teams up with the American College of Physicians to create an online program that facilitates creation of medical homes

Frank Diamond


The Formulary Files

Drug cost-sharing amounts stable 2010–2011


News & Commentary

Search for Specific Information When Reviewing PCMH Studies


News & Commentary

Keep Benefit Summaries Simple