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Defined Contribution: Magic Bullet?
Defined contribution is a re-emerging health care reform idea. Its advocates say that it tackles reforms overlooked by other options, will tame costs, and will give employers incentive to stay in the game.
When a health plan contracts with a PBM, it should insist on strict definitions of brand drug and generic drug, an experienced negotiator advises
$10B to Study Payment Systems
Under PPACA, CMS is directed to test new payment models, leaving advocates holding their collective breath
Provenge Approval Means Sensitive Coverage Decisions
Coverage of this costly biologic for prostate cancer is generally being provided under very specific circumstances
Interim Federal High-Risk Groups May Far Exceed $5B Allocation
Not only is the program expected to be short on cash, but many patients may not be able to afford even the subsidized rates
A Conversation with Ted Eytan, MD: Social Media Are Your Friends
He started blogging to get information out to physicians; now he believes that patients too will benefit greatly from e-mail, blogs, tweets, and the like
Helping Hispanics Means Improving Preventive Care
Bracing for an influx of enrollees, medical managers at some plans take creative approaches to fixing a decades-old problem
Holistic Care Management Requires IT Integration
When we truly begin to manage the person and not the condition, there will be payoffs on both the cost and quality fronts
Departments
EDITOR’S MEMO
Defined Contribution Health Care Could Really Shake Up the System
LEGISLATION & REGULATION
Coverage, Recission Reviews to Get Tougher in Some States Under Reform
Health reform requires a uniform process for member appeals, and the NAIC approach has been adopted by the Department of Health and Human Services
COMPENSATION MONITOR
Pay raises in store for clinical executives
THE FORMULARY FILES
Strengthening diuretics’ role in hypertension
PLAN WATCH
Program Keeps Dually-Eligible Adults Out of Nursing Home
Emblem Health is starting slowly with an effort that demographics nearly guarantee will catch on in New York and across the country
TOMORROW’S MEDICINE
New Players Enter Field of Regenerative Medicine
Biotechnology companies are doing promising work in producing new organs, with one adult stem cell therapy standing a good chance of approval in Canada
MANAGED CARE OUTLOOK
PPACA causes short-term increases in costs
News & Commentary
CDHP Enrollment Grows More Slowly
Chemo Treatment Rates Increased Under Medicare Modernization Act
Study Reports On LTC Costs
Headlines On Deadline …
Providers lag in ICD-10 readiness
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.