August 2012
Under health reform, consumers will be the new buyers in public and private exchanges, meaning care management programs will need a sharper focus on return on investment
Joseph Burns
As providers scramble to form accountable care organizations, insurers take steps to either participate, or limit ACO market power
Thomas Reinke
ACOs can learn from successes and mistakes of managed care, says Kaiser Permanente physician leader
John Marcille
While the United States has been in turmoil over how to tame its excessive health care bill, the Brits have their own problems — different, but in some ways the same
Robert Royce, PhD
In large part, the growth of specialty pharmacy will require pharmacy benefit managers to become more active on behalf of payers and patients
Warren K. Williams
Departments
Legislation & Regulation
In nonconforming states, health plans will miss out on a bonanza of new members and hospitals might be on the hook for uncompensated care
John Carroll
Medication Management
The Food & Drug Administration’s approach to this stage of a drug’s life cycle is inadequate
Tom Reinke
Evidence Review
Many insurers have not yet updated their coverage policies since the FDA cleared this scanning tool in November 2011
Compensation Monitor
The Formulary Files
Plan Watch
Blue Cross Blue Shield of Michigan teaches effective interviewing techniques to nurses on the front lines of chronic disease
Frank Diamond
Tomorrow's Medicine
Clinical trial data from the lorcaserin submission suggest modest weight loss over a short period
Thomas Morrow, MD
Managed Care Outlook