June 2015 - Managedcaremag.com

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The ACO Gamble

It has been tried again and again. But government and private payers are wagering on ACOs as a way to hit the health care jackpot: managed costs and high quality.

Robert Calandra

Pioneer ACOs get props for financial, quality results

Speaking Plainly: How One Health Plan Ungobbled the Gook

Are confusing, repetitive, jargon-ridden communications souring your member relations? Take a look at how Medica, a Minneapolis health plan, is tackling the problem.

Timothy Kelley

Confronting the Epidemic of Opioid Overdoses

Health plan efforts include identifying at-risk members and prescribers who write an unusually large number of opioid prescriptions.

Larry Beresford

4 Steps to Boost Your Medicare Star Ratings and Retain Your Customers

Vanessa Pawlak

Assessing the Financial Condition of Provider-Sponsored Health Plans

Michael J. McCue, DBA

Departments

LEGISLATION & REGULATION

Texas’s Corralling of Telemedicine Won’t Start a National Stampede

The Lone Star State may be a lone wolf when it comes to regulating virtual visits.

Richard Mark Kirkner

MEDICATION MANAGEMENT

MS Drug Going Generic Without Making Waves

Generics for other diseases have upended formularies, but the effect of generic Copaxone may be limited.

Thomas Reinke

MEDICAL DEVICE MONITOR

Unique Identifiers for Medical Devices Could Help Payers Determine Value

A low bar for market entry leaves health plans unsure of the value of devices. Adding a unique identifier for each product could help with decision making.

Katherine T. Adams

FORMULARY FILES

Biogen’s aducanumab raises hope that Alzheimer’s can be treated at its source

Krishna Rutvij Patel

SNAPSHOT

More infants suffering from withdrawal

Not only did the number of infants with neonatal abstinence syndrome increase dramatically from 2004 to 2013, but the proportion of NICU days devoted to caring for those infants increased to 4% in 2013 from just 0.6% in 2004, according to a study in the New England Journal of Medicine.

TOMORROW’S MEDICINE

New Treatment for Melanoma Uses a Form of the Herpes Virus

The investigational product coaxes the immune system into attacking the deadliest skin cancer. But can we afford these expensive cancer drugs?

Thomas Morrow, MD

MANAGED CARE OUTLOOK

Private exchange enrollment predicted to swell to 40 million by 2018

News & Commentary

Ophthalmologists Blind To Changes in Guidelines

Obesity Paradox Shows Up In Study

Registries Called Underdeveloped

Major antibiotic shortages create clinical woes

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Paul Lendner

Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.