Managed Care

 

 

October 2012

For decades, managed care plans have sought to stop paying fees for services. Now they’re trying bundled payments for episodes of care.

Joseph Burns

It might not be the road to totally overcoming the fractured nature of the health care system, but it should lead to better collaboration

Bob Franceschini

Medicaid plans in some states will expand, putting pressure on plans’ primary care networks

Richard G. Stefanacci, DO, MGH, MBA, AGSF, CMD

Learning these lessons from the Veterans Health Administration, the nation’s largest integrated system, leads to organizational success

Robert L. Jesse, MD, PhD

The researchers find that the costs of treating restless legs syndrome are fairly low, relative to the improved symptoms and associated health care outcomes, and are mainly attributable to prescription medication. Health plans are encouraged to expand coverage to reduce the associated suffering and costs.

Juliana Meyers, MA ; Sean Candrilli, PhD ; Richard Allen, PhD ; Ranjani Manjunath, MPH ; Michael Calloway, PhD



Departments
Editor's Memo
John Marcille
Legislation & Regulation

Hospitals now face stiff penalties and some health plans see this as a way to attain a long-sought goal

John Carroll
Medication Management

Analytical studies, rarely used to evaluate biotechnology products, will need greater attention

Tom Reinke
Compensation Monitor
Plan Watch

Intermountain Healthcare’s checklist for providers cut mortality rates for this fast-moving, and sometimes lethal, condition

Frank Diamond
Managed Care Outlook
News & Commentary

Meetings

4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015

Our other journal

P&T Journal for September 2014

Features

Health Care & Law

Legal Risk Management Opportunities, Pharmacy Practice, and P&T Committees

Hospitals Struggle With ACA Challenges

Drug–Gene Interactions: Inherent Variability in Drug Maintenance Dose Requirements

Schizophrenia: Overview and Treatment Options

Pipeline Plus

Schizophrenia Therapy Options Increasing

Departments

Medication Errors

Too Many Abandon the “Second Victims” of Medical Errors

Prescription: Washington

New Controversy for 340B: OPA Rebuffs Ruling by Court

New Drugs/Drug News/New Medical Devices

Pharmaceutical Approval Update

Drug Forecast

Loxapine Inhalation Powder (Adasuve)