PET, CT, MRI — these and other imaging technologies are valuable but costly. Aetna, Cigna, and a few other plans lead in clamping down on unnecessary use.
Some of the nation's best health plans are coming up with creative ways to encourage women to get mammograms.
The private sector drags its feet over Ambulatory Payment Classifications. Here are some suggestions to move acceptance along.
Renee Leary, MPH
Dean Farley, PhD
The health plan was listing badly when Charles Baker boarded it in 2000. Since then, the ship has been righted and the way is clear.
Pay-for-performance (P4P) programs promise a fair shake for provider and plan, but a former chairman of the NCQA sees many design flaws to overcome.
Alice G. Gosfield, JD
The physician-author of “Overdosed America” says that health plans have a logical role in actively assessing the medical literature.
A federal agency fashioned to oversee drug research might inhibit the creation of new medications. The quest for profit in itself may generate benefit.
Legislation & Regulation
The $50 million needed for regional collaborations was not part of the federal government's budget. Not the end of the world, but not good either.
The Formulary Files
Natalizumab has received FDA approval. But as with all approved treatments, questions remain about efficacy and clinical importance compared to existing therapies.
Thomas Morrow, MD
Managed Care Outlook