September 2008

Messing With Medicare Advantage

With Congress engineering big changes, plans are likely to face cuts unless legislators take a new approach to fixing the physician pay formula
References to maximum allowable prices in contracts between plans and PBMs need to be scrutinized, since things are not always what they seem

MedPAC Proposals Echo Private Payers’ Own Concerns

The Medicare Payment Advisory Commission is asking Congress to promote primary care and to hold providers accountable
Patient satisfaction remains an important characteristic of a health plan, particularly at open enrollment time. WilsonRx’s annual survey tells the tale.

Departments

EDITOR’S MEMO

Switchover to ICD-10 Codes Poses a Daunting Challenge

LEGISLATION & REGULATION
Their argument in California is that insurers should spend a minimum of 85 percent of their revenue on services
MEDICATION MANAGEMENT

Dose Consolidation May Not Be Worth the Trouble

A low return on investment and high implementation costs keep dose optimization from taking hold in some pharmacy benefit programs
COMPENSATION MONITOR

Public would pay for pharmacist input

THE FORMULARY FILES

‘Doughnut hole’ leaves 3.4M without coverage

PLAN WATCH

Plan Hopes $3,000 per Oncologist Results In Improved Cancer Care

Blue Cross Blue Shield of Michigan makes it easier for oncologists to get information that will help them improve quality, cut costs
TOMORROW’S MEDICINE

OraVerse Helps You Lose That Numbing Feeling

A common gripe with oral anesthetics is the amount of time it takes for them to wear off
MANAGED CARE OUTLOOK

Health costs decelerate, yet still climb fast

News & Commentary

NCQA Unveils Quality Measures

Employers Turn To CDHPs, Wellness

Uninsured Spend $30 Billion Out of Pocket, Study Says

Health care falls to fourth among hot presidential topics

Headlines On Deadline . . .

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