April 2009

Insurers know that the new tests can be valuable, but have trouble evaluating them and may not even know exactly which ones they are paying for

Emad Rizk, MD

Kaiser Permanente’s experience proves that plans play a valuable role in ensuring that all Americans have access to care
Medicare is expected to lead payment reform, but major players in the private sector are banding together to move it along

Lola Butcher

Sharp Health Plan wanted to increase mammography screening for its at-risk female population. Thirty percent of at-risk members were non-adherent. Members’ reasons for avoiding screening were examined.

Sandra R. Parkington, MPH, RN Nora Faine, MD, MPH Marcia C. Nguyen Michelle T. Lowry, MPH Poorva A. Virginkar

Departments

LEGISLATION & REGULATION
Legislators look for a way to help payers and patients cope with the high cost of biologics without destroying the businesses that made these products possible
John Carroll
MEDICATION MANAGEMENT
The agency believes current attempts to control prescribing and distribution of opioids and other strong painkillers is inadequate
Martin Sipkoff
TOMORROW’S MEDICINE
An electronic device is applied to the forehead in a 40-minute treatment, causing depolarization of neurons
Thomas Morrow, MD
PLAN WATCH
Insurers will be judged on how well they find and serve groups whose health outcomes have historically lagged
Frank Diamond

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