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Managed Care August 2004 Martin Sipkoff	Bad Tiered Formulary Designs Yield Poor Outcomes, High Cost Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
Managed Care July 2007 Martin Sipkoff	Lowering Copayments Can Improve Quality of Chronic Disease Care Employers and health plans are starting to see the advantage of what has been termed evidence-based benefit design.
Managed Care August 2004 MargaretAnn Cross	Employers Take the Lead In Drug Benefit Design Companies test new approaches to funding the pharmacy benefit with the goal of saving money overall.
Managed Care October 2004 Arthur Lazarus	Formulary Restrictions Sometimes Harm Patients Much more research is needed to determine the full effect of drug benefit designs. Quality must be the foremost concern.
Managed Care May 2007 Rachel M. Renshaw	Keys to Diabetes Control? Patience, Persistence, and Perseverance Careful attention to a comprehensive treatment plan could forestall or prevent the need to add drugs and costs to a patient's regimen.
Managed Care May 2003 Wayne Miller	Higher Drug Copays Now Might Cause Problems Later The long-term impact of noncompliance must be considered before copayments are increased. This is especially true where chronic conditions are concerned.
Managed Care October 2007 Martin Sipkoff	Asheville's Legacy: Pharmacy Moves From Dispensing to Clinical Management It is an idea whose time has finally come: Today's clinical pharmacists are involved in virtually all aspects of medical care.
Nursing Management January 2012 Lawrence et al.	Type 2 Diabetes: Growing to Epic Proportions Affecting all age groups and all aspects of a person's life, diabetes is a major public health issue worldwide, requiring lifelong behavioral and lifestyle changes and support.
BusinessWeek October 22, 2009 Arlene Weintraub	Tough Love, Lower Health Costs A UnitedHealthcare plan offers incentives to employees who strictly control their diabetes.
Managed Care May 2006 Martin Sipkoff	Health Plans Are Ill-Prepared for Looming Diabetes Epidemic The problem is outpacing insurers' resources and perhaps even their commitment. Can the chronic care model help?
Managed Care March 2007 Louis W. Hutchison	Unable to Carry Cost Burden, Payers Seek Other Remedies The pharmacy benefit landscape of today is all but unrecognizable from its predecessor of just a decade ago. Blending an approach that uses education, reward, and penalty can rein in runaway health care costs
Managed Care December 2003 Martin Sipkoff	Health Plans Begin To Address Chronic Care Management As with so much else in health care, observing protocols, analyzing data, and rethinking benefit designs are important.
Managed Care December 2003 MargaretAnn Cross	Will New Benefit Design Harm Some Patients? In the past, reducing demand for care by raising patients' costs has resulted in the loss of some needed care. Can we avoid the trap?
Managed Care August 2001 Steve Perlstein	Four-Tier Approach Injects Consumerism Into Drug Benefit In tying copayments closely to the actual cost of medications, Humana takes a step toward promoting awareness of resource use...
Nursing January 2011 Carl A. Kirton	HIV: The Changing Epidemic Since its emergence in the early 1980s, HIV infection in the United States has evolved from an acute debilitating condition to a chronic, treatable illness.
Managed Care August 2004 Alan Lotvin	Specialty Pharmacy Presents Unique Set of Challenges Only a small percent of a typical health plan's population takes medicine for conditions outside the generalist's scope. But it's a big portion of the drug bill.
Pharmaceutical Executive November 1, 2012 Lauri Mitchell	Who Pays for Specialty Medicines? Providers and patients fish for that delicate balance between access and abandonment.
Pharmaceutical Executive December 1, 2011 William Looney	The Medicines Adherence Challenge Keeping skittish patients on their medicines ought to be a strategic priority for Big Pharma, but is it? An expert round table examines how best to make progress and agree on some practical steps for incorporation in the campaign agenda.
Managed Care December 2003 Tony Berberabe	Why Do FEHBP and Big Unions Excel at Managing Drug Costs? Pharmacy benefit managers can do only so much to keep drug price increases in the single digits. Initiatives instituted by health plans can help in this effort.
Managed Care June 2006 John Carroll	When New Drugs Are Costly, How High to Raise Copays? As some pretty costly, yet very useful, drugs are introduced, will new formulary designs deny access to needy patients?
Pharmaceutical Executive August 1, 2011 Jennifer Ringler	The Adherence Fight: A TKO? Why does the match against medicines compliance always seem to end in an easy knockout?
CIO July 1, 2004 Alice Dragoon	An Ounce of Prediction When health-care costs spiked, predictive-modeling software uncovered the reasons why and suggested a radical plan for containing future expenses and improving employee health.
Pharmaceutical Executive June 1, 2014 Ben Comer	Take as Directed: From Force to Finesse in Promoting Adherence Healthcare players tout patient education and engagement as the keys to better drug adherence rates. Patients agree, as long as that translates to convenient and affordable access to therapy.
Pharmaceutical Executive April 1, 2006 Humphrey Taylor	Opinion: Unintended Outcomes for Consumer-Drive Insurance So-called "consumer-driven" health insurance is designed to help informed consumers make better decisions about their medical treatment. But the high deductibles associated with these plans are affecting the end goal.
Managed Care July 2002 Thomas Kaye	Managing the Drug Benefit: One Company's Experience The pharmacy director of Blue Cross of Oklahoma shares his company's success with using three tiers and coinsurance to promote member responsibility.
American Family Physician January 15, 2007 Pollock et al.	Appropriate Prescribing of Medications: An Eight-Step Approach These eight steps, along with ongoing self-directed learning, compose a systematic approach to prescribing that is efficient and practical for the family physician.
Managed Care September 2004	Cost-Related Underuse of Heart Meds Leads to Cardiac Complications The study is significant because it is the first nationally representative longitudinal study to demonstrate that patients with serious chronic illnesses experience adverse health events when they restrict their use of prescription drugs due to cost.
Nurse Practitioner March 2012 Baumann & Dang	Helping Patients with Chronic Conditions Overcome Barriers to Self-Care Here are approaches nurse practitioners can use to reduce or eliminate barriers to self-care in adults with chronic conditions.
Managed Care April 2002 Paula Sirois	HMOs Should Prepare Now To Get Handle on Injectables With more than 360 biotech products in the pipeline, high-cost injectable drugs are about to flood the market. How will we control the expenditure?
Managed Care February 2001 T. Jeffrey White	Making Pharmacoeconomics In Formulary Development a Reality Despite what might be commonly believed, pharmacoeconomics is not a widely used tool for formulary development. Here's a model to follow...
Pharmaceutical Executive August 1, 2008 George Koroneos	Hard of (Ad)hering Companies have responded to declining profits with a proliferation of patient compliance programs. But where is pharma in this paradigm shift?
Managed Care February 2007	Study: Copayments do Affect Compliance Managed care decision makers have a powerful tool that affects patient compliance with antihypertensive medications - the copayment level.
American Family Physician October 15, 2003 Gavin et al.	Reducing Cardiovascular Disease Risk in Patients with Type 2 Diabetes By increasing patient awareness of the link between diabetes and heart disease, family physicians can encourage patients to take medications (including aspirin), stop smoking, lower blood pressure, and lower cholesterol and blood glucose levels.
CFO June 1, 2010 Alix Stuart	"This Is the Era of Smarter Medicine." A prescription-drug provider says it can thrive even as it helps drive down health-care costs. An interview with Richard Rubino, CFO, Medco Health Solutions Inc.
American Family Physician October 15, 2005 Coleman & Newton	Supporting Self-Management in Patients with Chronic Illness Family physicians can support patient self-management by structuring patient-physician interactions to identify problems from the patient perspective, making office environment changes that remove self-management barriers, and providing education individually and through available community self-management resources.
Nurse Practitioner April 2010 Benninger & McCallister	Asthma in pregnancy: Reading between the lines Asthma is one of the most common, chronic medical conditions that can complicate pregnancy, affecting between 4% and 8% of this population.
Managed Care September 2007 John Carroll	Do Out-of-Pocket Payments Put Preventive Care on Hold? Studies by Cigna and Humana challenge some long-held assumptions about high-deductible plans.
Managed Care May 2001	Old Ideas About Formulary Structure Gone as Humana Tests 4-Tier Model Humana is phasing in a four-tier formulary that categorizes prescription drugs by costs, rather than generic or brand status. The higher the drug's acquisition cost -- regardless of whether it's a branded or generic product -- the higher the tier it lands in...
Managed Care November 2005 Patrick Mullen	This Biologics Industry Spokesman Knows That Health Plans Can Only be Won Over by the Financial Argument. Biotech's focus is expanding from products that treat relatively rare diseases to treatments for conditions that affect much larger populations, including various cancers, diabetes, rheumatoid arthritis, and asthma because of health plan costs.
Managed Care July 2003 Bob Carlson	Predictive Modeling, Sharp Lens on Near Future The concept is not new, and there might not be total truth in advertising, but it is rapidly gaining acceptance as a technique to control costs and disease progression.
Pharmaceutical Executive November 1, 2013	Roundtable on Market Access Market Access is a window on what matters in the real world of soaring patient expectations and crimped payer budgets for innovation.
Managed Care November 2003 Gold & Kongstvedt	How Broadening Disease Management's Focus Helped Shrink One Plan's Costs Blue Cross and Blue Shield of Minnesota and American Healthways score a hat trick by improving outcomes and satisfaction while saving money.
American Journal of Nursing May 2010 Corbridge & Corbridge	Asthma in Adolescents and Adults This article outlines current guideline recommendations for asthma and reviews what clinicians need to teach patients about its pathophysiology, pharmacotherapy, self monitoring, and environmental control.
Nursing May 2010 Debra Castner	Understanding the stages of chronic kidney disease This article will help you to recognize CKD and understand its stages so you can help your patient to modify risk factors, prevent further kidney damage, and manage complications. First, consider the scope of the problem.
Nursing September 2010 Margaret M. Bolton	Sounding the alarm about metabolic syndrome Any health problem that affects a third of American adults is sure to impact your nursing practice. Metabolic syndrome, a growing and commonly silent condition, poses a significant public health crisis.
American Family Physician November 15, 2002 Cynthia M. Williams	Using Medications Appropriately in Older Adults Finding the right balance between too few and too many drugs will help ensure increased longevity, improved overall health, and enhanced functioning and quality of life for the aging population.
Searcher June 2012 Stephanie C. Ardito	The Medical Digital: How Safe Are the Prescription Drugs we Take? Monitoring Adverse Events and Recalls For general information about prescription and clinical trial drugs, the following websites have been around for a while and have excellent reputations.
Nurse Practitioner February 2012 Wood & Gordon	Preventing CVD in women: The NP's role This article focuses on the new American Heart Association guidelines for preventing cardiovascular disease in women and the nurse practitioner's role in implementing them.
Managed Care July 2005 Tony Berberabe	Change in Thinking For Pharmacy Benefits in CDHP The difference between the pharmacy benefit in a consumer-directed health plan and a traditional health plan is greater generic drug utilization.
Managed Care April 2002 Rhonda Greenapple	HMOs Have Stake in Quelling Anger at Drug Store Counters Dissatisfied customers have a tendency to lash out and not be very discriminating about their targets. Prescription: Reduce the hassle...