Managed Care
Disease
Management

 

February 2014

Rates are far too high, and health plans are big losers. Is it time to institute financial penalties?

Joseph Burns

Insurers want to obey laws, but those laws are hard to understand and it is tempting to simply define coverage equality downward

Joseph Burns

But not just nursing homes. The former CMS chief wants to create efficiencies in all post-acute care settings, and looks to health plans as customers.

Can an injectable biologic really replace a delicate surgery for treatment of Dupuytren’s disease?

Jack McCain

A bigger portion of the population is expected to have cardiac disease but live longer, and researchers argue for stopping it before it shows

Frank Diamond

Moody’s says that more people will get care, but hedges its prediction, while other experts think that the trend line will stay flat

Frank Diamond

A new precertification procedure addresses key elements in genetic testing

Thomas Reinke



Departments
Legislation & Regulation

The system’s effect on the private sector has actually been underestimated. Medicare price changes often lead to amplified swings on the private side.

John Carroll
The Wider View

Compulsory medical insurance with a twist: Plans play a crucial role

Robert Royce, PhD
Plan Watch

Despite last year’s fiasco at Penn State and growing concern about the effectiveness of such programs, employers are still believers

Frank Diamond
The Formulary Files
Krishna R. Patel, PharmD, RPh
Tomorrow's Medicine
Genome squencing has gotten so cheap that it takes oncologists’ breath away. It also raises thorny issues for health insurers.
Thomas Morrow, MD