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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 October 2004 John Carroll	DM Industry Jumps for Joy Over Medicare's Leap of Faith The Center for Medicare and Medicaid Services has implemented 10 pilot programs that may very well be viewed as a make-or-break test for disease management.
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 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 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 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 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 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 2005	There's Now a Correct Method For Defining ROI in Disease Management Health care consultant Al Lewis, the godfather of disease management, talks about how the industry went wrong, and is now going right, in describing its own value to health plans, public employers, and the government.
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 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 July 2007 Tom Reinke	Better Ways to Pay Providers Paying for coordinating care and for packages of services -- bundling and episodes of care -- may be the best bet for a modification of the unfettered fee-for-service system.
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 September 2005	New Research Throws Doubt On DM's Cost-Effectiveness Health plans and other providers of disease management services might do better to emphasize the pursuit of better outcomes, rather than guaranteed savings, a new study implies.
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 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 February 2004 John Carroll	DM Standards Off and Crawling When American Healthways posted a collaborative methodology on its Web site, not everyone in the industry applauded.
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.
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 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 May 2004 Frank Diamond	Care Coordination Strikes Right Chord Care coordination -- which, for the purposes of this article, means optimal management of people with multiple chronic diseases to improve outcomes and cut costs -- just suddenly seems a lot more doable. The thing that may make care coordination work this time, is technology.
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).
Financial Planning April 1, 2007 Joan Warner	What's Next for Medicare Is America's retirement healthcare plan really in trouble? Here's some good news -- and some hard decisions for your financial advisory clients.
Managed Care January 2008 Peter Kongstvedt	The Managed Care Forecast Here are some of the challenges that health insurers face this year.
Managed Care November 2001	Medicare+Choice Problems Chasing Away 58 Health Plans Medicare+Choice, the program that was supposed to ease the elderly into managed care, is itself suffering from the uneasiness of HMOs dissatisfied with payment rates...
Managed Care November 1999 Arthur L. Baldwin III	Financial and Risk Considerations for Successful Disease Management Programs Results for disease management programs have not been as positive as hoped because of clinical issues, lack of access to capital, and administrative issues....
Managed Care March 2006 Taylor & Eck	It's Time for CMS to Release Physician Medicare Claim Information The Center for Medicare & Medicaid Services is a rich source of price and quality data. Isn't it about time it shared that data?
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 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.
Managed Care May 2006 John Carroll	Medicare Debates Fairness of Pay For Primary Care and Specialists A growing controversy in MedPAC and in physician organizations could spill over into how all health plans compensate doctors.
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.
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...
Managed Care August 2007 Martin Sipkoff	Soaring Price of Cancer Drugs Leads Plans To New Approaches Insurers are trying different methods, from pay for performance to promoting preventive care, to hold down cost of chemotherapy drugs.
Managed Care December 2001	Disease Management Outsourcing As DM shifts its focus to outcomes-based care, the EVP of American Healthways suggests that larger health plans consider outsourcing care of chronic patients.
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 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 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.
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 September 2007 John Carroll	Who Gets Covered, Junior or Grandma? America's Health Insurance Plans is mounting a very public campaign aimed at portraying a House bill as a measure that robs enrollees of essential benefits.
Managed Care February 2001	In Medicare Bill, HMOs Got What They Wanted When the dust cleared over how $35 billion in Medicare "givebacks" would be divided, the Republicans prevailed -- Medicare HMOs got a bigger cut than Democrats wanted to give them. Now, President Bush may be poised to give Medicare managed care plans more...
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.
Managed Care October 2001 Michael Levin-Epstein	Medicare+Choice Reform: Hope, but No Quick Action Expected There have been small accomplishments, and wheels have been churning for more forceful action -- that is, they were until Sept. 11...
The Motley Fool January 22, 2007 Dan Caplinger	Understanding Medicare: Benefits Medical coverage for seniors is a big part of a strong retirement-protection plan.
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...
Managed Care February 2004 John A. Marcille	The Administration Delivers A Major Gift to Managed Care Which brings me to the announcement that Medicare payments to health plans participating in what was called Medicare+Choice but is now known as MedicareAdvantage will increase by a record 10.6 percent.
Managed Care December 2004	Headlines On Deadline ... Preferred Provider Organizations participating in Medicare Advantage can satisfy federal oversight requirements if they've already received accreditation from the National Committee for Quality Assurance.
Managed Care April 2005	Headlines On Deadline ... More public universities are requiring students to have health coverage... The price tag for the Medicare prescription drug benefit keeps growing... We're living longer, according to an examination of more than 2.4 million death certificates... etc.
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.
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?