Managed Care
Disease
Management

 

November 2014

Plans and health systems are collaborating with walk-in centers to keep patients out of the ERs. Investors like what they’re seeing.
Richard Mark Kirkner
Where they are, what they are, and how many there are
Peter Wehrwein
As prisoners sign up for the program under health reform, insurers must learn to cope with a problematic population
Nan Myers
New regulations, EMRs, maintenance of certification, and concern about cost are burdens for physicians, but things will improve, says this year’s president of the American College of Physicians
John Marcille
Albert I. Wertheimer, PhD, MBA ; Frances A. Brentson, MS



Departments
Legislation & Regulation
Plans make the case that what patients pay above reference price for services should not count
Richard Mark Kirkner
Medication Management
Liraglutide, used to lower HbA1c levels, can also aid with weight reduction. Should health plans cover it for this use?
Thomas Reinke
The Formulary Files
Krishna Rutvij Patel, PharmD
Medical Device Monitor
Katherine T. Adams
Tomorrow’s Medicine
By measuring the inflammatory marker CD154, Pleximmune promises to predict the risk of organ rejection in liver and small-bowel transplant procedures
Thomas Morrow, MD
Managed Care Outlook