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March 2010

Features

Cover Story

DM Grows, Though Under Fire
Some question disease management’s cost-effectiveness, but major insurers have seen enough to induce them to expand programs

Many States Preparing Laws Rejecting Individual Mandate
The most attractive element of the congressional reform plan — at least in the eyes of insurers — is drawing fire in at least 30 states

HIEs Are Slow Going But Critical Part of HIT
Many states, helped by a few health plans, are striving to develop health information exchanges, encouraged by federal stimulus funds

Small Hospitals Face Heavy Weather
They’re endangered by a brutal combination of factors, a report last August declared, but things may not be so bad as they looked then

Peer-Reviewed

Opioid Use Patterns and Health Care Resource Utilization in Patients Prescribed Opioid Therapy With and Without Constipation
Findings of this retrospective database study further emphasize the importance of effectively managing the side effects of opioid pain therapy and achieving optimum clinical and economic outcomes, thus improving the quality of care

Departments

Editor’s Memo
Less-is-More Approach Now Under Heavy Fire

Medication Management
Antidepressants Work Best For the Severely Depressed
Studies suggest that the benefits of the medications for mild-to-moderate patients are minimal or nonexistent

Medication Management
Specialized support programs increase treatment adherence, reducing relapses for multiple sclerosis patients

Compensation Monitor
Low-performing docs benefit most from P4P

Snapshot
Doc shortage slows Medicare Advantage growth

The Formulary Files
Plans not mining data that could prevent falls

Tomorrow’s Medicine
MelaFind Improves Chances for Accurate Melanoma Diagnosis
Will insurers provide coverage for a new device that takes much of the guesswork out of screening for this deadly skin cancer?

Plan Watch
Put DM in Doctors’ Hands?
Disease management should be a function of primary care, some industry proponents argue. Did someone say patient-centered medical home?

Managed Care Outlook
Premium growth to reach 7.1% by 2015

News

Pay Docs More For Better Services
Headlines On Deadline
Savings Seen With Evidence-Based Care
Plans Balk While Patients Clamor for Robotic Surgery
More outpatient surgeries taking place

Continuing Education Credit

Growth Hormone Treatment: Evidence, Practice, and Emerging Issues

The effects of growth hormone deficiency (GHD) on the stature and maturation of children are well established. Recombinant DNA technology now allows the production and use of recombinant growth hormone to correct those effects without the limitations and safety concerns associated with growth hormone (GH) derived from pituitary tissue. GH therapy is also gaining acceptance for treating idiopathic short stature (ISS) in children whose growth rate is subnormal but who have no GH deficiency or other endocrine abnormality. The normal aging process in adults is accompanied by a substantial decline in GH, and recent research supports the damaging effects of GHD associated with atherosclerosis and osteoporosis. Other research is investigating GHD as a factor in chronic fibromyalgia and AIDS. This continuing education program provides information on the current status of GH therapy for children and adults so that managed care professionals can better understand the diagnostic and treatment algorithms and the scientific rationale for expanded use of GH therapy.

Highlights:
  • Clinical Management of GH Therapy for Children
  • Clinical Management of GH Therapy for Adults
  • Plan and Pharmacy Perspectives
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