Managed Care


March 2007

Health plans are increasingly involved in promoting the lifestyle changes that help their members avoid cancer, and are increasingly involved in clinical trials if prevention fails
Martin Sipkoff
Increasingly, health plans are providing disease, case, and utilization management when a beneficiary receives a cancer diagnosis
Lola Butcher
Medical care involves choice, and often consumers go with the less expensive option when given all the facts
MargaretAnn Cross
Its 2007 HEDIS physician performance manual puts greater emphasis on cost of care
Tom Reinke
Implementing what was formerly called the Chronic Care Model can improve an organization's response to this widespread problem
Therese Zink, MD, MPH ; Karen Lloyd, PhD, LP ; George Isham, MD ; David J. Mathews, PsyD, LICSW ; Terry Crowson, MD

Editor's Memo
John Marcille
Legislation & Regulation
Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split.
John Carroll
Blending an approach that uses education, reward, and penalty can rein in runaway health care costs
Louis W. Hutchison Jr.
Medication Management
Widespread adoption of this technology is inevitable, yet physicians still resist. Various coalitions and initiatives are trying to make adoption easier.
Martin Sipkoff
Employer Update
The programs are well received, for the most part, even though it is still hard to measure their value
Lola Butcher
Tomorrow's Medicine
An absorbable polyester material holds great promise beyond its primary use as a new type of surgical suture
Thomas Morrow, MD