Managed Care



August 2009

Plans and payers are looking at a new insurance design that puts quality first. It might also save money.
Martin Sipkoff
Coverage often straddles the line between the pharmacy and medical benefit, but a properly constructed formulary can bridge the gap
F. Randy Vogenberg, RPh, PhD
Radiology benefit management programs and the launch of new guidelines may slow utilization
Lola Butcher
Unfortunately, most contracts practically invite the companies that health plans deal with to manipulate prices
Linda Cahn
A ‘health insurance czar’ might not make the final bill, if there is one, but the proposal evokes centuries-old tension
Frank Diamond
Legislators are looking closely at ways to prevent fraud and enforce new marketing and educational regulations
John Liethen<br/> and Jonathan Bakewicz

Editor's Memo
John Marcille
Legislation & Regulation
Just who gets paid for what — and how much — is expected to change in a big way in 2010
John Carroll
Medication Management
The FTC warns that the competition between ‘follow-on’ biologics and the pioneer products is likely to be of the brand-vs.-brand variety
Martin Sipkoff
Compensation Monitor
Tomorrow's Medicine
This competitor of clopidogrel will probably be most useful for patients in the initial phases of acute coronary syndrome
Thomas Morrow, MD
Plan Watch
Retail stores offer “young invincibles” and the working poor the chance to examine low-cost coverage options
Frank Diamond


4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015