June 2012

Cover Story
Seeking the best return on shared-savings programs such as PCMHs and ACOs, health plans are investing cash and other resources to attract and hold patients’ attention
Joseph Burns
Ingenix was criticized for understating UCR rates, but newer formulas also enrage members who get big balance bills
John Carroll
This time the messenger matters as much as the message. Are specialists gearing up for life after fee-for-service?
Frank Diamond
Highmark’s CMO seeks new and improved models of health care delivery
John Marcille
High costs mean a sea change in cancer management is urgently needed, and these tools can chart the way without eroding the physician’s role
William J. Sullivan, MBA
When physicians don’t know how compliant their patients are, the health plan can step up
Tammy Worth
Legislation & Regulation
Large insurers worry what will become of the hard work and money expended on the conversion if some providers get their way
John Carroll
Medication Management
Formulary managers need to make head-to-head comparisons of dabigatran and other anticoagulants used to treat atrial fibrillation
Thomas Reinke
Evidence Review
A summary of ECRI Institute’s Emerging Technology Evidence Report
Tomorrow’s Medicine
Elelyso, derived from plant-cell technology, avoids many of the problems encountered when mammalian cells are used to create drugs
Thomas Morrow, MD
News & Commentary