October 2011

The National Business Group on Health’s CEO looks for employers and insurers to collaborate to improve patient safety and cut costs
Once in a while something comes up that requires the sort of immediate and intense intervention that’s downright heroic
Lax regulations and fee-for-service payment make an irresistible mix for physician conflicts. Are ACOs the answer?
Medco’s ‘gaps in care’ approach saves $900 million by targeting 15 chronic conditions
This is no one-size-fits-all solution, as insurers across the country tailor efforts for specific markets
A widely available but underused molecular genetic blood test has proved to be accurate over 98% of the time and costs less than $400

Departments

VIEWPOINT
In a system where people will soon shop for their benefits on exchanges, plans that offer the best customer service will have the edge
MEDICATION MANAGEMENT
Health plans are expanding MTM — once considered a Part D mainstay — to their commercial businesses.
EVIDENCE REVIEW
A summary of the ECRI Institute’s Emerging Technology Evidence Report
LEGISLATION & REGULATION
The need for health plans to cut administrative costs is hammering insurance brokers. Is this another instance of the law of unintended consequences?
TOMORROW’S MEDICINE
Brilinta’s price will be a significant factor in coverage decisions when Plavix goes off patent in May 2012
PLAN WATCH
If UnitedHealth Group’s effort to buy a large physician group proves successful, clinical execs will have even more oversight

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