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Managed Care January 2001 John Carroll |
Florida Leads the Way in Attempting Disease Management for Medicaid Officials across the country are watching to see whether the Sunshine State's innovation can save money... |
Managed Care September 2005 John Carroll |
DM Industry Confident It Can Hit Medicare Goals Though there are challenges to serving the elderly, the movers and shakers of disease management say that they should be able to cut costs in pilot populations by 5%. |
Managed Care June 2002 John Carroll |
DM and Medicare: A Marriage Made in Heaven? With a budget of about $230 billion for 40 million patients, many with chronic ailments, is it any wonder that disease management and Medicare are courting? |
Managed Care August 2005 Maureen Glabman |
12 DM Trends You Should Know About The government joins health plans, providers, employers, and pharmaceutical companies in seeking to establish disease management's value |
Managed Care November 2004 Frank Diamond |
DM's Cost-Effectiveness Doubted in CBO Report Congress's financial review agency says that not enough evidence exists to prove that disease management saves money. Many beg to differ. |
Managed Care April 2005 Frank Diamond |
Starting Medicare Advantage Plan Brings Special Set of Problems The feds will help you launch a health plan for the elderly, but just what does it take to get something like this operating in so short a time? |
Managed Care March 2008 |
CMS Hybrid Payment System Shows Promise Combining Medicare fee-for-service payments with new incentive programs could help physician groups save money for Medicare and reach quality-of-care targets. |
Managed Care September 2004 John Carroll |
Pfizer: DM Did Not Fizzle In Florida Medicaid Ruckus Medicaid officials close the books on a program the pharmaceutical giant contends that soon-to-be-released data will verify its disease management program's effectiveness. |
Managed Care March 2007 John Carroll |
Democratic Agenda Places Medicare Advantage at Risk Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split. |
Managed Care November 2000 John Carroll |
Health Plans Demand Proof That DM Saves Them Money Can disease management vendors really show a strong return on a health plan's investment, or are the data just too malleable to be useful? |
Managed Care September 2000 John Carroll |
Mergers, Acquisitions Afoot In Disease Management Industry Within a few years, there may be only 30 DM companies left, says one expert. HMO customers want vendors to handle more than one condition... |
Pharmaceutical Executive May 1, 2005 Erik Felker |
Elephant or Specialist? The Bush Administration has put in place the groundwork for new market forces that will forever change how pharmaceuticals are commercialized. Although the long-term impact of this change is not known, unprepared companies are at a serious disadvantage. |
Managed Care July 2002 |
Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1. |
Managed Care February 2004 John Carroll |
New Medicare Risk Adjustments Bad News for Unprepared HMOs Getting less-than-hale elderly enrolled can finally be a sound business strategy for HMOs that comprehend the new rules and have sufficient IT capability. |
Managed Care October 2000 |
Quick Fix May Be in Store for M+C, But Meaningful Change Likely To Wait Whatever diversion prescription drug proposals have provided, Medicare+Choice is back on Congress's radar screen. While sentiment is again running strong among legislators to address the wounded program, Congress is now racing a clock ticking ever closer to the elections... |
Managed Care September 2006 John Carroll |
Managed Medicare Revitalized: Feel-Good Plan of the Decade Insurers are largely happy with what they've seen. They're creating new benefit packages and expect more business in the next one to three years. |
Managed Care April 2002 Frank Diamond |
Medicare+Choice: Uncertain Future for Unstable Program While policy makers haggle over President Bush's budget request for the system, an ominous question looms: Can money solve all the problems? |
Managed Care April 2006 Maureen Glabman |
'Take My Word for It': The Enduring Dispute Over Measuring DM's Economic Value While disease management is now mainstream, it can still be difficult to judge a program's worth. Health plans faced with renewing these contracts have a lot to think about. |
Managed Care March 2005 |
'This Country Cannot Continue With the System We Now Have' As a vice president of Pfizer Health Solutions, a major disease management company, John Sory knows how difficult it is to bring systematic care to the chronically ill. He discusses Pfizer's work with Florida's Medicaid program. |
Searcher October 2011 Stephanie C. Ardito |
The Medical Digital: Navigating the Medicare Maze Since entitlement programs are the chief governmental programs under fire, I decided to revisit the healthcare bills passed back in March (H.R. 3590, the Patient Protection & Affordable Care Act). |
Managed Care September 2002 |
Medicare holds down physician pay Compensation increased at a comparatively small rate from 2000 to 2001 for both primary care physicians and specialists, according to the Medical Group Management Association. |
BusinessWeek February 4, 2010 Terhune & Weintraub |
Take Your Meds, Exercise -- and Spend Billions Washington wants to pump big money into so-called disease management, though there's scant evidence that it works. |
Managed Care March 2007 |
Use of Generics On the Rise Recent data indicate that generic medication accounts for nearly 60% of the drugs dispensed to people in Medicare Prescription Drug Plans and Medicare Advantage plans. |
Knowledge@Wharton July 30, 2003 |
Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall. |
Managed Care April 2005 |
Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation. |
Managed Care July 2000 Michael Levin-Epstein |
Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen. |
Managed Care October 2001 |
CMS Defends Plan To Let States Tailor Medicaid Benefits Centers for Medicare and Medicaid Services Administrator Thomas Scully has defended the Bush administration's plan to allow states to opt out of mandatory Medicaid-coverage requirements... |
Managed Care October 2001 Michael Levin-Epstein |
Medicare Demonstration Projects Seek To Coordinate Chronic Care The Centers for Medicare and Medicaid Services is awaiting the results of landmark demonstration programs to determine if improved Medicare services can be furnished to chronically ill patients without increasing costs... |
Managed Care March 2002 John Carroll |
DM Vendors Start To Address Costs Created by Comorbidities Some vendors are moving from offering just a few programs to embracing systems that try to deal with all the complicated overlaps... |
The Motley Fool January 22, 2007 Dan Caplinger |
Understanding Medicare: Claims In general, Medicare provides a level of coverage that is fairly similar to what private health insurance plans offer. Here are some tips for getting the most from it. |
Managed Care July 2007 |
AMA: Patients Will Feel Cuts in Medicare Next year's proposed 10 percent cut in Medicare payments is serving as a rallying point for members of the American Medical Association, which says the cuts will make it difficult for physicians to accept new Medicare patients. |
Pharmaceutical Executive August 1, 2013 Jill Wechsler |
Costs and Coverage Challenge Medicare Drug Plans Rate cuts and fraud concerns create problems for Part D plans and Part B providers. |
Managed Care March 2002 Michael Levin-Epstein |
Illinois's Medicare Drug Program Called 1st Stab at National Reform The Illinois demonstration program gives the state permission to use federal and state Medicaid dollars to provide prescription drug coverage for 365,000 low-income, elderly Medicare beneficiaries... |
BusinessWeek July 14, 2003 Howard Gleckman |
This Medicare Reform Is No Cure The theory: The shift will improve treatment and save taxpayers money, helping to rein in ballooning Medicare costs while offsetting the expense of the drug benefit. Those are laudable goals. Unfortunately, Congress isn't likely to achieve them. |
The Motley Fool June 21, 2005 Stephen D. Simpson |
American Healthways Sneezes Investors took the stock down after earnings, but the company is still in good health. |
Managed Care May 2006 |
Headlines On Deadline . . . Health plans appear to be having some trouble fulfilling a federal mandate that 80 percent of questions from Medicare beneficiaries about pharmacy coverage be answered within 30 seconds. |
Pharmaceutical Executive June 1, 2005 Jill Wechsler |
Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs. |
Financial Planning April 1, 2010 Donald Jay Korn |
Medicare: Change is Coming This is a great time to get together with clients over 65 who will be affected by health care changes and go over their Medicare coverage. At the same time, you can see what other areas of financial planning are on their mind. |
Managed Care June 2003 Alison Johnson |
Measuring DM's Net Effect Is Harder Than You Might Think Disease management is God's gift to managed care. Or is it? Here is a discussion of areas that make evaluating a DM program a complex, if not ineffable, proposition. |
Managed Care October 2002 |
Though M+C Erosion Slows, Reimbursement Still an Issue The exodus of health plans from Medicare+Choice will moderate somewhat next year, offering hope that the struggling system can make a comeback. |
Managed Care February 2005 |
Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players. |
Financial Planning November 1, 2007 Donald Jay Korn |
Medicare Choices What are Medicare private fee-for-service plans and why did their fortunes rise and fall so dramatically? Most important, if these plans survive in their current form, should advisors suggest them for clients enrolled in or approaching Medicare eligibility? |
Managed Care October 2007 John Carroll |
Medicare Coverage Rules Are Not Always Last Word Yes, commercial health insurers often take a cue from the government, but that doesn't mean that they follow blindly. |
BusinessWeek October 10, 2005 Howard Gleckman |
Medicare's Big Experiment The coming changes to Medicare aim to cut costs while improving care. Sound familiar? |
Managed Care May 2005 |
Implementing Medicare Part D Could Get Ugly This expert who hopes to help everybody adjust, nevertheless expects big headaches come Jan. 1, 2006. However, e-prescribing could make the drug plan work. |
Knowledge@Wharton |
Prescription Drug Coverage for Seniors Faces Uncertain Future The discussion about adding a prescription drug benefit to Medicare will be put on hold... |
Managed Care September 2006 |
We Can't Avoid Tough Decisions Forever Former Reagan administration official Jeanne Scott is working to change how health information is processed. However, that's only part of the solution. |
Pharmaceutical Executive December 1, 2008 Jill Wechsler |
Challenge and Challenges Expanded healthcare coverage also fits the goals of pharma manufacturers. |
Managed Care May 2007 Frank Diamond |
Medicare Advantage Hits Jackpot with Private Fee-for-Service Plans The secret to the success of Medicare private fee-for-service plans is as old as gold. Will beneficiary satisfaction force Congress to keep the faucet turned on? |
Managed Care May 2004 John Carroll |
Bush vs. Kerry: Upcoming Election Offers Real Debate on Health Care Despite the focus on the international situation, Americans are still keenly interested in just how they'll get the medical care they need. |