May 2006

The problem is outpacing insurers’ resources and perhaps even their commitment. Can the chronic care model help?
The goal of diabetes management is maintaining glycemic control while targeting quality of life improvements
It’s one of the few areas where plans can economize effectively. BlueCross & BlueShield of North Carolina is one of many insurers that are changing members’ and prescribers’ behavior.
“How could the largely private U.S. health care system, characterized by arguably more competition than any other health care system in the world, be performing so poorly?”
Can primary care physicians persuade health plans and Medicare to accept their version of the chronic care model?

Departments

LEGISLATION & REGULATION
A growing controversy in MedPAC and in physician organizations could spill over into how all health plans compensate doctors
MEDICATION MANAGEMENT
Medication therapy management helps people to stay on their prescribed regimens. Part D plans can expect to start making payments for the service in 2007
ETHICS
Current pay-for-performance programs apply only to a handful of diseases. If we don’t pay for all the other diseases, will they get short shrift?
TOMORROW’S MEDICINE
While biologic agents can be costly, a new formulation of an old treatment can mean inexpensive and effective relief

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