October 2012

Cover Story

For decades, managed care plans have sought to stop paying fees for services. Now they’re trying bundled payments for episodes of care.

Joseph Burns

It might not be the road to totally overcoming the fractured nature of the health care system, but it should lead to better collaboration

Bob Franceschini

Medicaid plans in some states will expand, putting pressure on plans’ primary care networks

Richard G. Stefanacci, DO, MGH, MBA, AGSF, CMD

Learning these lessons from the Veterans Health Administration, the nation’s largest integrated system, leads to organizational success

Robert L. Jesse, MD, PhD


The researchers find that the costs of treating restless legs syndrome are fairly low, relative to the improved symptoms and associated health care outcomes, and are mainly attributable to prescription medication. Health plans are encouraged to expand coverage to reduce the associated suffering and costs.

Juliana Meyers, MA ; Sean Candrilli, PhD ; Richard Allen, PhD ; Ranjani Manjunath, MPH ; Michael Calloway, PhD

Editor’s Memo

John Marcille

Legislation & Regulation

Hospitals now face stiff penalties and some health plans see this as a way to attain a long-sought goal

John Carroll

Medication Management

Analytical studies, rarely used to evaluate biotechnology products, will need greater attention

Tom Reinke

Evidence Review

A summary of ECRI Institute’s Health Technology Forecast Report

Plan Watch

Intermountain Healthcare’s checklist for providers cut mortality rates for this fast-moving, and sometimes lethal, condition

Frank Diamond

News & Commentary