Managed Care

 

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F. Randy Vogenberg, PhD, RPh: The growth of specialty pharmacy products and changing ownership patterns for medical practices can complicate delivery and administration of some patients’ treatments.

Pressure related in part to health care reform has encouraged narrow networks that not only help limit costs but also improve safety by promoting greater consistency and patient education, particularly with specialty products. — F. Randy Vogenberg, PhD, RPh

F. Randy Vogenberg, PhD, RPh: Given the high costs of specialty drugs, sponsors of health plans (especially self-funded ones) are gathering information on costs, benefits, and outcomes to determine what kinds of coverage to offer.

In the rapidly evolving market for hepatitis C virus treatments, much more effective medications with higher price tags will require careful cost-benefit analyses, says F. Randy Vogenberg, PhD, RPh.

Despite the convenience of smartphones, tablets, and the many applications they offer to aid physicians, some health care experts are worried about the concerns mobile devices may raise relating to consistency, accuracy, security, and synchronization with other platforms, says F. Randy Vogenberg, RPh, PhD.

As they evaluate the performance of their health care vendors, employers are focusing less on cost and more on performance: What are the outcomes for the money they're spending? 

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“I am definitely excited about where primary care is going,” says the founding dean of the Jefferson School of Population Health, and the Dr. Raymond C. and Doris N. Grandon Professor of Health Policy at Thomas Jefferson University. Here he speaks with John Marcille, editor of Managed Care, and Sonja Sherritze, editor of P&T, about what drives his enthusiasm.

Randy Vogenberg, PhD: The differences among the latest diabetes medications are seen as less than dramatic, creating questions about the costs and benefits of the various new treatment options. Meanwhile, patient compliance remains a concern.

Electronic health records have progressed further in hospitals and health systems than they have in doctors' offices and pharmacies; financial and technical difficulties continue to slow full implementation warns F. Randy Vogenberg, PhD, RPh.

As pharmacies begin to look at how they will be paid for their efforts to effectively manage the growing number of specialty products under health care reform, mergers and acquisitions are accelerating in an effort to broaden resources.

F. Randy Vogenberg, PhD, RPh: Contrary to its intent, the Affordable Care Act has decreased access to primary care physicians while at the same time reducing support for the education of new doctors who could help relieve that problem.

Meetings

Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL 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