January 2006

Insurers need a coverage strategy that focuses on reducing post-surgical complications and avoiding adverse selection

Catherine M. Murphy-Barron

Urged on by employers traumatized by costs, health plans are renewing their interest in prior authorization, but using a lighter hand

Martin Sipkoff

The health care economist says that consumers ought to share in the savings from making the right choices. Insurers, providers, and hospitals should make sure that options exist.
Aetna incorporates a program developed at the University of Pennsylvania to deliver services where members live

MargaretAnn Cross


Recent court ruling means that beneficiaries should be notified about insurers’ decision-making powers
John Carroll
Changes in reimbursement patterns for obesity drugs will take several years. Lifestyle changes remain the first approach.
Martin Sipkoff
Should a new (and cheap) test for chronic lymphocytic leukemia be a component of prior-authorization protocols?
Thomas Morrow, MD