September 2008

Predictive modeling programs are ready for prime time. David Eddy describes Archimedes and what it can do for insurers, patients, and doctors.
John Marcille
With Congress engineering big changes, plans are likely to face cuts unless legislators take a new approach to fixing the physician pay formula
John Carroll
References to maximum allowable prices in contracts between plans and PBMs need to be scrutinized, since things are not always what they seem
Linda Cahn
The Medicare Payment Advisory Commission is asking Congress to promote primary care and to hold providers accountable
Lola Butcher
Patient satisfaction remains an important characteristic of a health plan, particularly at open enrollment time. WilsonRx’s annual survey tells the tale.

Legislation & Regulation
Their argument in California is that insurers should spend a minimum of 85 percent of their revenue on services
John Carroll
Medication Management
A low return on investment and high implementation costs keep dose optimization from taking hold in some pharmacy benefit programs
Martin Sipkoff
Plan Watch
Blue Cross Blue Shield of Michigan makes it easier for oncologists to get information that will help them improve quality, cut costs
Frank Diamond
Tomorrow's Medicine
A common gripe with oral anesthetics is the amount of time it takes for them to wear off
Thomas Morrow, MD