With Wing and Prayer, But Without a Blueprint

John Marcille

We're all over the place, this month. A magazine can be compared to a car that's assembled by engineers challenged to build something without a blueprint. What emerges will run, often very well, but who knows what it will look like?

This month we're surprised, again, by just how much a many-tentacle thing is managed care. Our managed care car takes us to far-flung places, such as those featured in our article on medical tourism, or into laboratories to find out just what health plans pay for and what they should demand, and to the P&T committee meeting table, where we discover that the clinicians guiding those panels sometimes do not have information about drug prices.

For theorists, there's our interview with McKesson's Emad Rizk, who sees a very different disease management on the horizon. Meanwhile, some marquee names in health care economics ponder, just what the world would look like if managed care had never been invented. "To be, or not to be...."

However, before that, you may want to read the cover story. Author John Carroll looks at an industry that is being reduced to a few big players in each market.

What does that mean for regional operators? Or quality? Or providers? Some who contract with insurers fear the consequences of consolidation. Are they warnings or are they threats? Our cover illustration, two well-dressed business titans locked in battle, may represent two huge health plans. Or, it may represent one huge health plan and one huge hospital company. Of particular concern is that little person pictured amongst the giants — the member?

Either way, it's a fight. We'll keep giving you the blow-by-blow.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

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