Managed Healthcare Executive - Managed care trends and analysis - benefit strategies for Medicare/Medicaid and commerical populations
Modern Medicine Network button
Managed Healthcare Executive Issue
Managed Healthcare Executive
Providing senior-level decision makers the comprehensive analysis, trends and strategies they need to innovate value in a rapidly changing healthcare landscape.
Technology
Transparency will influence how members choose providers
Some plans are unable to disclose negotiated provider rates, but members need the data.
Quality programs best served with clinical data analytics
Paying for performance will cause many health plans to rethink how they contract with provider networks, and experts say there are tremendous changes ahead.
Data sharing will reduce variation
When it comes to predicting geographic variations in cost, what's true for Medicare doesn't necessarily hold for the commercial populations.
Secondary use of health data increases security risks
Patient privacy remains a key issue for health plans, according to a new survey conducted by PricewaterhouseCoopers (PwC).
Advanced call center models measure more than just talk time
The interface for health plan member services must keep up with new demands.
Previous StoryPlay / PauseNext Story
Insight From Our Columnists
Exclusive Features
Karen Davis to step down from Commonwealth Fund
November 2011
Davis leaves a legacy of health policy research and practical improvments
HealthSpring a good fit for Cigna
October 2011
Cigna recognizes potential of Medicare Advantage market
AMCP announces new CEO
October 2011
Edith Rosato will take over for long-time CEO Judith Cahill, who announced retirement plans earlier this year.
FAQs: AmeriHealth Mercy acquisition
August 2011
On August 9, Independence Blue Cross and Blue Cross Blue Shield of Michigan announced their alignment
Disease management outcomes measurement requires mathematical proof
December 2010
The Disease Management Purchasing Consortium (DMPC) and Zenger Analytics have completed a mathematical proof to address the question of valid outcomes methodologies for disease management, wellness, medical home and other population-based care management programs for which outcomes are calculated on a pre/post basis.
Optimize the effectiveness of health and wellness offerings
August 2010
For any savvy health insurer that expects to remain competitive in the increasingly challenging industry, health and wellness programs are no longer novel. Rather, the offerings of a health and wellness program have evolved into an imperative way to engage current and potential customers, as well as positively affect an organization's bottom line.
 More Articles
Health Management
Osteoporosis treatments have several dosing options
January 2012
Osteoporosis and low bone density affect about 44 million Americans. Bisphosphonate treatment can reduce the risk of fractures in people with osteoporosis by 40% to 50%.
Cost pressures bite into dental packages
January 2012
With employers feeling ever more price pressure, it's no wonder their workers are paying more for dental and vision
Coverage policy for genetic tests should reflect clinical utility
December 2011
Adding to the complexity is the emerging science of smart medicine, that is, the delivery of effective care based on personal attributes of the patient
Plans make coverage decisions in light of PSA testing guideline
December 2011
The U.S. Preventive Services Task Force (USPSTF) is no longer recommending the prostate-specific antigen (PSA) screening test for healthy men
Plans re-evaluate their COPD programs in light of changes
November 2011
New drugs to treat chronic obstructive pulmonary disease have increased treatment options.
Dispel myths among members who fail to get their flu shots
November 2011
The biggest challenge health insurers face each year is convincing members to get their flu shots.
 More Articles
Click here