Managed Healthcare Executive, Jun 1, 2009 - Managed Healthcare Executive
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Managed Healthcare Executive, Jun 1, 2009
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Special Report
The Public Plan Option: Is It Dead Yet?
By Julie Miller
House and Senate leaders included a public plan in initial legislative framework, but few believe the policy holds a cure for healthcare
Technology
Objective measures define EMR adoption levels
By David Bennett
Providers jockey for the stimulus funds for the adoption of EMRs, few hospitals get beyond half-way through the EMR adoption stages.
For Your Benefit
Spending grew 7.4% from 2008 to 2009
By Julie Miller
Industry and members have two different perceptions about what they are paying for medical and pharmacy costs. It's your job to educate members about comparative effectiveness.
Hospitals & Providers
Pay claims now or pay later with dissatisfied members
By Tracey Walker
Shifts in benefit design may have providers commiserating more with members about your payment practices
Pharmacy Best Practices
Pharmacy benefit has practical advantages for specialty drugs
By Mari Edlin
Utilization management will play a larger role, and a separate benefit will emerge specifically to manage high-cost specialty drugs
Health Management
Coverage mandates for autism debated at state, federal levels
By Shelly Reese
At the heart of the debate are therapies that insurers consider educational in nature, and therefore, do not warrant health-benefit coverage
State Report
State Report: Nevada
Commonwealth Fund State Performance Ranking (2007): 6
Politics and Policy
Insurers pledge to back health system reforms
By Jill Wechsler
Major concessions aim to dilute support for other, more onerous regulations
Letter of the Law
Mental-health legislation in effect for most in 2010
By Barry Senterfitt , Janet Farrer
Financial considerations, treatment offerings and networks must be comparable to medical benefits
Managed Care Outlook
Medicare could benefit from radiology management
By David Soffa, MD
A GAO report said Medicare spent $14 billion in five years on radiology. RBM could help reduce those costs.
News Analysis
Medicare insolvency due to high MA payments
By Jill Wechsler
Private fee-for-service plans are under scruntiny as perhaps being partly responsible for skyrocketing Medicare expenditures.
Recession hits managed care
By Tracey Walker
Rethink benefit options and watch for new consolidations in your local provider market
Insurers pledge to cut spending growth
By Jill Wechsler
Providers, plans and pharma companies promise to produce savings through tried and true methods, but skeptics doubt they'll make any sacrifices
Early details pitch public plan as co-op
By Tracey Walker
A proposal by Senator Kent Conrad (D-N.D), to establish member-run healthcare ?co-operatives? is gaining attention.
Research Briefs
Research Briefs: June 2009
Summaries of recent research
Exclusives
It's time for a new model of health management
By Ron Geraty, MD
A new personal health support model is emerging, a model that more accurately describes what we are able to do with individuals within the population.
EMRs not enough? Technology changes the paradigm
Most projected models make the assumption that the EHR industry will continue as it has evolved to-date, with very expensive, proprietary, locally-installed client-server systems.
Adapt to changes with automation
By Darryl Low
Because healthcare is constantly in flux, organizations must have the agility to adapt and respond to continuously changing market conditions
Leverage clinical decision support
By Barry Chaiken MD
Empowering consumers with clinical knowledge assists in the delivery of safer, more efficient care that offers higher-quality outcomes.
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.
2008 Leaders in Disease Managment
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