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Managed Care March 2008 Frank Diamond	What Makes Harvard Pilgrim So Good? It's the nation's leader in member satisfaction and quality of care, according to NCQA. Dynamic leadership and dominance of a region where excellent docs and plans abound are part of the formula.
BusinessWeek June 13, 2005 Timothy J. Mullaney	Hunting For Hospitals That Measure Up New Web sites can help you become an educated health-care consumer
CFO February 1, 2007 Karen M. Kroll	Pin the Tail on the Doctor A dearth of information leaves health-care consumers in the dark. As health-care information becomes more accessible, will employees use it to purchase health-care services more intelligently?
Managed Care January 2005 Ed Silverman	The Comeback Kid: Harvard Pilgrim Health Care The health plan was listing badly when Charles Baker boarded it in 2000. Since then, the ship has been righted and the way is clear.
Managed Care May 2002 John Carroll	Hospital Copayments: At What Cost? High daily copayments for high-priced hospitals are coming into fashion. It's all about shifting costs, but what about quality of care?
Managed Care March 2006 MargaretAnn Cross	Deciding Factor: How Much Health Care is Discretionary? Defining discretionary health care is no easy task, but it may be imperative for 'consumer' health plans seeking to get patients more involved.
Managed Care February 2007 Maggie Mahar	Why Market Competition Will Not Mend Our Health Care System Doctors have a saying: 'Half of what we know is wrong.' In which half is the conventional wisdom that competition is society's best hope for improving quality and controlling costs?
The Motley Fool July 17, 2006 Querna & Fischman	Good Medical Help Close to Home Your local hospital might be just as good as any glittery big-name center. Finding out if your local hospital is up to snuff requires some homework. Here are the major factors in judging the quality of care, courtesy of U.S. News & World Report's annual "America's Best Hospitals" issue.
Managed Care October 2007 John Carroll	Early Tiered Networks Encounter Many Obstacles From dodgy data to uncooperative doctors, difficulties confront health plans that are trying to stratify providers by cost and quality.
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.
Managed Care November 2003 Martin Sipkoff	9 Ways To Reduce Unwarranted Variation Unwarranted variation in medical practice is costly -- and deadly. When the approach in one town is major surgery and in another, it's watchful waiting, you know there's a problem.
Managed Care August 2002 Frank Diamond	Moving Consumers to the Head of the Class Creating a customer base that's aware of the link between cost and services has become the next big challenge in managed care. It's a daunting task.
Managed Care December 2004 Martin Sipkoff	A Better Case for Quality: Share the Savings! Brent James's research has led to a new and powerful vision of paying for performance that binds physicians, plans and hospitals together.
Managed Care October 2004 MargaretAnn Cross	Consumer-Directed Care Bets Against Human Nature How many patients have the intelligence and skills to choose on the basis of medical quality?
CRM August 1, 2009 Lauren McKay	Healing the Sick Facing regulatory requirements, spiraling costs, and an aging (and ailing) customer base, the healthcare industry looks to CRM to balance a pair of age-old doctrines: First, do no harm - and physician, heal thyself.
Nursing Management June 2011 LaRocco & Pinchera	The emerging trend of medical tourism Although it's difficult to find accurate data, there's general agreement that the number of Americans seeking medical care abroad is growing.
BusinessWeek November 12, 2009 Catherine Arnst	10 Ways to Cut Health-Care Costs Right Now Employers and hospitals don't have to wait for Congress to address inefficiencies and waste.
Nursing Management November 2011 Mary Ann Remshardt	The Impact of Patient Literacy on Healthcare Practices With regard to patient teaching, how can healthcare personnel be certain that patients understand concepts basic to informed consent, hospital safety, dietary restrictions, and prescription information?
Managed Care May 2005 MargaretAnn Cross	Are Consumers Really Directing Their Own Care? In theory, consumer-directed health plans put the reins of decision making into the hands of their members. But medical management departments are alive and well inside CDHPs -- and may even expand under these plan designs.
HBS Working Knowledge June 29, 2015 Dina Gerdeman	Consumer-centered Health Care Depends on Accessible Medical Records John Quelch discusses approaches to integrate patient data so that medical professionals and patients can make better decisions.
Managed Care September 2007 Martin Sipkoff	Go Carefully When Measuring Quality Gauging and rewarding good work in health care is a noble goal with potentially negative consequences.
Fast Company May 2009 Chuck Salter	The Doctor of the Future Cost, access, quality -- the prognosis for American health care may look grim, but innovation is the cure. The medicine of tomorrow is being born today.
BusinessWeek June 9, 2009 John Carey	Giving Patients the Data They Need A growing effort by doctors, insurers, and politicians helps people make better-informed medical decisions
HBS Working Knowledge April 4, 2011 Carmen Nobel	Attention Medical Shoppers: What Health Care Can Learn from Walmart and Amazon At a Harvard Business School discussion on health care management, experts looked to the retail industry as a possible model for delivering medical services more effectively and inexpensively.
Nursing Management April 2009 Sharon H. Pappas	Profits, Payers, and Patients: Responding to Changes Profit is necessary for hospitals to fulfill their missions, invest in expansion and new technologies, and reinvest in existing patient care infrastructures. Profitability is the work of the financial team and the clinical team to produce the hospital's desired financial outcome.
Pharmaceutical Executive March 1, 2014 William Looney	The Call to Community: A Conversation with Dr. David Nash Population health is the foundation for much of what is truly new in US health reform. For big Pharma, it represents yet another escalation in expectations.
CFO May 1, 2009 Josh Hyatt	Strong Medicine Boosted by a substantial injection of cash from the federal stimulus bill, electronic medical records may help relieve the pain of rising premiums by improving efficiencies in the medical system.
Managed Care December 2006 MargaretAnn Cross	Confronting The Medicare Cost Shift Plans are increasingly concerned about the degree to which providers overcharge them to make up for losses from government programs.
American Family Physician August 1, 2005 Safeer & Keenan	Health Literacy: The Gap Between Physicians and Patients Inadequate health literacy can result in difficulty accessing health care, following instructions from a physician, and taking medication properly. Patients with inadequate health literacy are more likely to be hospitalized than patients with adequate skills.
IEEE Spectrum October 2006 Robert N. Charette	Dying for Data A comprehensive system of electronic medical records promises to save lives and cut health care costs -- but how do you build one? The many technical, social, and political issues are also formidable.
Commercial Investment Real Estate May/Jun 2013 Mauldin & Maddron	Medical Office Momentum The Affordable Care Act takes some risk out of healthcare property investment.
Pharmaceutical Executive August 1, 2005 Lena Chow	Docs of Shanghai They're short on status, pay, and respect, but China's young doctors hold keys to the world's fastest growing pharmaceutical market.
Managed Care June 2001 Jack McCain	Leapfrog Group Actions Will Be Felt Throughout the Health Care System Thanks to a Business Roundtable-sponsored group calling for better outcomes at hospitals, health plans' lobbying efforts may pay off...
Managed Care October 2003 Ed Silverman	Tough Negotiations in Store Between Plans and Hospitals Fallout from the Medicare outlier-payment scandal is likely to force hospitals to try to replace that revenue. Health plans, prepare to negotiate!
CIO December 15, 2009 Kim S. Nash	Data Sharing That Benefits Customers At Children's Hospital Boston, sharing more data, securely, promises healthier, more satisfied patients.
BusinessWeek January 7, 2010 Catherine Arnst	Hospitals: Radical Cost Surgery A hospital that slashes costs - and delivers high-quality care as it innovates? Yes, it exists.
Managed Care May 2007 MargaretAnn Cross	Following the Leaders Top pay-for-performance programs point to increased focus on hospital incentives, efficiency measures, coordination, and standardization.
Nursing Management October 2011 Edna Cadmus	Your role in redesigning healthcare We need to rethink how we provide care and to understand the interconnectedness and the structure of healthcare by looking at it as a whole vs. the sum of its parts. As leaders we need to view the evidence as we rethink healthcare together.
Managed Care February 2002 Alan M. Muney	Evidence-Based Medicine Needs To Be Promoted More Vigorously This means using a carrot-and-stick approach with physicians. Those who respect the evidence should be rewarded; others should face penalties...
Managed Care February 2007 Maureen Glabman	Health Plans Can Learn From VHA Turnaround While plans, hospitals, and physician groups talk the talk, the Veterans Health Administration is walking the walk.
Managed Care September 2003 MargaretAnn Cross	Consumer-Directed Health Care: Too Good To Be True? People talk about it as the sure way to control costs and give consumers the choice they seem to want. Are we being realistic?
Commercial Investment Real Estate Sep/Oct 2009 Andrew Dick	Deal Diagnosis Healthcare real estate transactions not only are driven by economic factors, but also by compliance with federal and state healthcare laws.
Nursing Management September 2011 Sally Austin	What does EMTALA mean for you? When a patient enters your hospital, do you know what your obligations are under the Emergency Medical Treatment and Active Labor Act?
Nursing Management September 2010 Richard Hader	The evidence that isn't... Interpreting research When patients seek a healthcare practitioner for services, they believe that the delivered care is based on proven science. But reality is far from patient perception. In fact, most care is still based on anecdote, not evidence.
Managed Care June 2005 Martin Sipkoff	The Re-Emergence of the Primary Care Physician A new model of care developed by the American Academy of Family Physicians places primary care physicians back at the center of care delivery.
Managed Care June 2007 MargaretAnn Cross	What the Primary Care Physician Shortage Means for Health Plans Insurers fear rising costs and poorer outcomes if members are less able to get appointments with family physicians and general internists.
Managed Care May 2003	Employer Coalition Leaps at Challenge of Grappling With Misaligned Incentives The executive director of the Leapfrog Group says that the organization pleads guilty to trying to create 'aspirational' standards for health care.
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 September 2005 Ed Silverman	No Easy Fit For Specialty Hospitals Insurers worry that specialty hospitals will ultimately increase costs at nearby community hospitals
Managed Care March 2007	Competition Wins Over Centralization Insurers who recommend a particular provider or health care organization to a patient considering a surgical procedure need to determine how complex the procedure is and how frequently the surgeon performs the procedure.