In the bad old days, health plans would contract with a limited number of providers, promising them lots of work in return for low prices. Now, a new generation of narrow networks takes a page from the old HMO playbook, adding fresh comparisons on quality that all providers will find hard to ignore.
If everyone can see what everyone is doing, we'll have better care at lower costs. First task: Create common standards.
There's a big push for passage this year, but don't hold your breath. Many feel that such a measure would be too expensive.
Initial results are promising. Employees turn toward preventive medicine and away from expensive drug therapies.
Y2K, 9/11, anthrax scares — these events crystallized the problem of medication stockpiling. How does managed care respond?
Omalizumab, a novel therapy that targets specific steps in the inflammatory cascade of asthma, may benefit the hard-to-treat patient.
Gailen D. Marshall Jr., MD, PhD
Christine A. Sorkness, PharmD
John A. Marcille
Legislation & Regulation
Federal backing aligns with market pressure to create an irresistible force. However, health plans need to be aware of some troubling issues.
It's easy to blame the uninformed, and sometimes fair, but are the ignorant the only ones at fault? Medical professionals need to be able to explain, not just order and direct.
Michael S. Victoroff, MD
The Formulary Files
Improvements in the features of diabetes pumps have evolved since their original backpack-size days. Managed care needs to evaluate the new bells and whistles.
Thomas Morrow, MD
Pepsi promises that work-site clinics won't take business away from health plans.
Managed Care Outlook