January 2010
FeaturesCover Story House Call Revival, Digital-Style
Telemedicine has different aspects, and one is the seemingly simple connection of a doc and a patient. When the stars are aligned, such an encounter can save money and time.
How Plans Can Improve Outcomes And Cut Costs for Preterm Infant Care
Ten percent of newborns are admitted to a neonatal intensive care unit. NICU costs are high but controllable.
Not Your Father’s Cadillac Plan
Just because a benefit package costs a lot doesn’t mean it pays for everything or improves outcomes. Many variables come into play.
States Collect Valuable Data On Hospital Prices and Performance
Pennsylvania’s mining of infection info, and the use of insurers’ own statistics in Maine are seen as great examples of measuring quality
Inpatient Rehab Facilities Benefit Post-Stroke Care
Rehabilitation at a skilled nursing facility lacks the intensity that most patients need, studies suggest
Episode-of-Care Payment Creates Clinical Advantages
It is customary to think of this payment method as a cost-control mechanism, and it is, but it can raise quality of care too
Higher Copayments and Deductibles Delay Medical Care, A Common Problem for Americans
CDHPs and catastrophic insurance plans can save consumers money, but do high deductibles add to overall costs down the line?
DepartmentsEditor’s MemoLooking Beyond Washington And Finding Much to DiscussLegislation & RegulationPlans Scramble to Defend Their Medical Loss RatiosCharges by lawmakers that insurers don’t spend enough on medical services lead to provisions in health reform bills in the Senate and HouseMedication ManagementStrict Regulatory Environment Dogs Cancer Pain ManagementAlthough effective treatments are available, helping patients cope is a minefield of administrative and legal barriersCompensation MonitorDocs paid faster, with fewer claims deniedThe Formulary FilesTesting alternatives to prior authorizationTomorrow’s MedicineNew Anti-Asthma Treatment Smooths Muscle in AirwaysIf the Food and Drug Administration approves the bronchial thermoplasty system, it will be the first device specifically approved to treat the conditionPlan WatchHospital Board Members Trained on Blues’ DimeA unique health plan-provider partnership focuses on giving practical knowledge to those to whom the CEOs reportManaged Care OutlookPoor in Part D plans face more premiums in 2010NewsBlues’ Payment Model Keeps Pace with Inflation
Mobile App Helps Members Find Docs
EMRs Fall Short Of Docs’ Expectations
Hospital Costs Soar For 10 Procedures
Headlines On Deadline
Quality ratings of Medicare Advantage plans
This Clinical Brief reviews the clinical information for SIMPONI™ (golimumab), which was approved by the U.S. Food and Drug Administration on April 24, 2009, for the treatment of adults with moderately to severe active rheumatoid arthritis (RA) in combination with methotrexate (MTX). It is also indicated for treatment of adults with active psoriatic arthritis, alone or in combination with MTX, and adults with active ankylosing spondylitis.
Highlights:
- SIMPONI™ is administered in a one dose, once a month subcutaneously via a prefilled autoinjector or prefilled syringe.
- SIMPONI™ has been studied in three phase 3 trials that enrolled different patients populations with respect to treatment. These multicenter, randomized, double-blinded, placebo-controlled trials included 1,542 patients age 18 or older with moderately to severely active RA.
- In these three trials, SIMPONI™ was shown to improve the signs and symptoms in patients with moderately to severely active RA. It also was shown to be efficacious in patients who are incomplete responders or naïve to MTX, as well as those patients who have been previously treated with at least one other anti-tumor necrosis factor agent.
Roy Fleischmann, MD, Clinical Professor of Medicine, University of Texas Southwestern Medical Center, and Co-Medical Director, Metroplex Clinical Research Center, Dallas, discusses this novel agent.
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Advances in treatment have helped patients manage chronic pain with pharmaceutical pain relievers, but some drugs — particularly opioids — carry the risk of dependence. Opioid dependence is a medical condition, and it can be treated, but employers may not know about all the treatments that are now available, or that they are covered by most health plans.
Not only are treatments covered by insurance, but the Americans with Disabilities Act and the Drug Addiction Treatment Act, passed by Congress in 2000, encourage employers to support employees with opioid dependency. Qualifying physicians may now treat opioid dependence directly, letting the abuser seek help in the privacy of a physician’s office rather than at a public clinic.
Highlights
- How opioids hijack the brain
- Ways in which employers deal with dependence
- Successful approaches to treatment
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