Managed Care


September 2009

Many see ACOs as the model for reform, but if provider groups dole out payment, then what roles will health plans play?
Frank Diamond
Physicians are really getting ticked off, just as they were in the ’90s, but it is possible to reduce their pain without abandoning the process
John Carroll
This spokesman for PBMs urges Congress to learn from his industry’s experience in driving down costs
Train an in-house team to help make the transition smooth by determining who is affected, and how
Jillian Harrington, MHA
They learned a lot from the avian flu scare of 2005 and are now ready to handle a swine flu epidemic this fall
Tony Berberabe, MPH

Legislation & Regulation
Despite all the talk about HIPAA privacy protections, there was little action. New regulations are intended to ensure compliance.
John Carroll
Medication Management
A Boston University law professor proposes that Medicare allow health plans to negotiate aggressively with pharmaceutical companies
Martin Sipkoff
Tomorrow's Medicine
The Melody Transcatheter Pulmonary Valve is delivered through cardiac catheterization, a favorable alternative to chest surgery
Thomas Morrow, MD