February 2013

Cover Story
Are We on the Way to a Real ‘Learning Health Care System’?

The fact that we waste hundreds of billions a year is all the more infuriating because we have the ability right now to stop the hemorrhaging
Joseph Burns
Aiming at a Moving Target In Rheumatoid Arthritis

As recommended treatment grows more aggressive, health plans should better manage both infusion and injectable medications
Thomas Reinke
Coverage With Evidence Development Allows Early Adoption, Better Evaluation

Health plans and providers can provisionally adopt promising therapies before all the evidence is in hand
Mark Perman, MD
More Data in Health Care Will Enable Predictive Modeling Advances

Rich data streams from electronic health records, when used appropriately, can transform population-based care management
David Bodycombe
Highmark’s Accountable Care Future Starts With Expansion of PCMH Model

A patient-centered medical home pilot project yields results that lead the health plan to launch a major effort
Frank Diamond
Managing Rapid Change In the Health Care Environment

Wrenching transformation in many forms is starting to be felt in many parts of the system. Here are ways to help resistant employees get on board.
Scott Guerin, PhD

Editor’s Memo
New Feature Focuses on Biotechnology Issues
John Marcille

Legislation & Regulation
EHRs Turning Out To Be Not as Wonderful as Expected

Meaningful use or not, electronic medical records are not delivering on the promise of improving care management
John Carroll

Medication Management
Insurers Expand Usefulness of Oncology Pathway Efforts

These programs tend to operate on the fringes of cancer care, but a movement to make them more central gains favor
Thomas Reinke

Physician assistants turn away from primary care

Biologics in Development
Another Cancer Vaccine, Another Retreat
Michael D. Dalzell

2012 drug approvals won’t be easy on pharmacy budgets

Book Review
How a Large Hospital System Profited by Putting Patients First

UCLA Health System went from bad to best, using a plan that emphasized increased respect for the patient
Peter Boland, PhD

Evidence Review
Total Knee Replacement Using Patient-Specific Templates

A summary of ECRI Institute’s Emerging Technology Evidence Report

Tomorrow’s Medicine
Relapsing Multiple Sclerosis Patients Can Look to Second Oral Agent

The recent approval of Aubagio (teriflunomide) provides an opportunity to conduct head-to-head trials in this expanding treatment category
Thomas Morrow, MD

Plan Watch
Value-Based Insurance Design Helps Cut Plan’s Diabetes Costs

UnitedHealthcare study unveils some impressive numbers, and now the company sets its sights on prediabetes
Frank Diamond

Managed Care Outlook
Commonwealth Fund sings bundling’s praises

News & Commentary
Pap Guidelines Followed — Mostly

News & Commentary
Transparency Depends On Consumers’ Rational Thinking

News & Commentary
Pediatricians’ Careers Influenced by Debt

News & Commentary
Cigna Sees Promise In Disability Program

News & Commentary
Social media mesh with dual eligibility

News & Commentary
Briefly noted
Medical Directors Forum Webinar

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