November 2011

Clinical executives at health plans want to see how providers react to draft recommendation against procedure

Frank Diamond

Discrimination persists in many areas, but slow progress is being made

Joseph Burns

With national attention on health care reform and new models of care, the NCQA’s VP for performance measurement looks at how quality improvement can stay at the forefront

John Marcille

Determining return on investment and improvement of outcomes is essential when new programs are being tried, but the research method must be chosen carefully

Andrew Kolbasovsky, PsyD, MBA

Departments

LEGISLATION & REGULATION
The gray market, where medications can be repriced, is becoming unmanageable
John Carroll
MEDICATION MANAGEMENT
Decision support tools provide new options for oncologists and health plans
Thomas Reinke
PLAN WATCH
Holding physicians to best-practice guidelines with the threat of refusing to pay for unnecessary tests reaps dividends
Frank Diamond
TOMORROW’S MEDICINE
Managed care once again faces the all-too-familiar debate about cost and benefit
Thomas Morrow, MD
MANAGED CARE OUTLOOK
Lipitor led the way, and other blockbusters are following

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