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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. mark for My Articles similar articles
Managed Care
January 2005
Leary & Farley
Health Plans Slow To Adopt Outpatient Prospective Payment The private sector drags its feet over Ambulatory Payment Classifications. Here are some suggestions to move acceptance along. mark for My Articles similar articles
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? mark for My Articles similar articles
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. mark for My Articles similar articles
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. mark for My Articles similar articles
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. mark for My Articles similar articles
Pharmaceutical Executive
March 1, 2011
Jerry Coamey
Engage the Physician! New research shows that gauging the mind of the clinician is crucial to timely uptake of the new diagnostic tools offered by the genomic revolution mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
April 2006
John Carroll
Some Specialist Societies Feel Left Out of AMA-CMS Deal on P4P Many physicians question the fairness of a deal between the American Medical Association and the government that give doctors a bonus when they follow certain rules. mark for My Articles similar articles
Managed Care
December 2007
John Carroll
How Doctors Are Paid Now, And Why It Has to Change Everyone knows about the perverse incentive of fee-for-service medicine, but that hasn't had much effect on its use. mark for My Articles similar articles
Managed Care
May 2002
Patrick Mullen
Interview: Thomas Scilly In a candid, wide-ranging interview, the Centers for Medicare and Medicaid Services administrator counsels patience in solving the myriad problems of health care. A fix could take 20 years mark for My Articles similar articles
Managed Care
July 2005
Martin Sipkoff
Is Pay for Performance Part of the Cure or the Problem? Paying for performance promises improved quality, reduced cost, and higher income for doctors. So why are some of them worried? mark for My Articles similar articles
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. mark for My Articles similar articles
Searcher
Jul/Aug 2010
Tara Breton
What's in the Patient's Medical Bill? If you want more understanding of medical billing, here are the basics of the U.S. medical reimbursement system that will hopefully assist you along with web resources on this subject. mark for My Articles similar articles
Pharmaceutical Executive
October 1, 2005
Phil Patrick
Marketing to Professionals: Senior-Care Specialists Surge In light of the growing senior population, pharmaceutical marketers are building partnerships with senior specialists. mark for My Articles similar articles
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. mark for My Articles similar articles
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. mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
January 2005
Alice G. Gosfield
P4P: Transitional at Best Pay-for-performance (P4P) programs promise a fair shake for provider and insurance plan, but a former chairman of the National Committee for Quality Assurance sees many design flaws to overcome. mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
May 2006
Martin Sipkoff
Part D Means Health Plans Will Have To Pay Pharmacists Medication therapy management helps people to stay on their prescribed regimens. Part D plans can expect to start making payments for the service in 2007. mark for My Articles similar articles
Pharmaceutical Executive
January 1, 2013
Al Topin
The Doctor-Patient Disconnect Doctor-patient conversations aren't always what we think; this basic interaction represents both a problem and an opportunity for today's drug marketers, says the author. mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
May 2000
Mark G. Weiner, M.D., and Eric Pifer, M.D.
Computerized Decision Support and the Quality of Care The notion of quality of care in medicine is not new, but it is becoming increasingly important as the competitive health care market demands objective measures to compare physicians, hospitals, and managed care organizations.... mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
March 2005
MargaretAnn Cross
Does Your Managed Medicare Plan Have Enough Geriatricians? There aren't enough geriatricians to go around, but judicious use of these specialists can still do a lot for an aged population. mark for My Articles similar articles
Managed Care
May 2004
Martin Sipkoff
Will Pay for Performance Programs Introduce a New Set of Problems? Paying incentives to physicians to practice evidence-based medicine appears to be an idea whose time has come. Such programs -- even if successful -- may create a new set of problems. mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
May 2006
Michael Levin-Epstein
Looking for a Better Way To Manage Care Can primary care physicians persuade health plans and Medicare to accept their version of the chronic care model? mark for My Articles similar articles
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? mark for My Articles similar articles
Pharmaceutical Executive
July 1, 2006
Jill Wechsler
Washington Report: Hard Evidence The push for more useful information on medication effectiveness is shaping drug development and reimbursement. mark for My Articles similar articles
Pharmaceutical Executive
October 1, 2010
When the Payer IS the Player As Medicare, Medicaid, and the nation's web of private payers gain market power, how can pharma stay ahead of the cost-containment curve? mark for My Articles similar articles
Managed Care
September 1999
Ed Rabinowitz
Is There a Doctor in the House? The per-visit cost of a house call is high, but used judiciously, this practice can lower overall medical costs -- not to mention provide better care. mark for My Articles similar articles
Managed Care
February 2008
Martin Sipkoff
Why Is It So Tough to Deliver On E-Prescribing's Promise? The push to mandate this electronic tool is increasing in intensity, but dealing with costs and coming up with standards remain obstacles mark for My Articles similar articles
Pharmaceutical Executive
November 1, 2005
Rubinstein & Galardi
Bustin' a CAP: The Competative Acquisition Program The new Competitive Acquisition Program for Medicare Part B drugs aims to align market forces with the distribution of drugs and biologics that doctors administer in their offices, but increasing bureaucracy is a major downside. mark for My Articles similar articles
Managed Care
March 2006
Standard Measures In Works For P4P Push Uncle Sam has decided to get behind the pay-for-performance effort in a big way, something some physician associations are less than thrilled about. mark for My Articles similar articles
Managed Care
April 2006
Pay-for-Performance Champions Excited by California Program's Success A quality incentive program in California is yielding results that could be replicated in Medicare and other pay-for-performance (P4P) programs nationwide according to a new report. mark for My Articles similar articles
American Family Physician
November 15, 2006
Liz Smith
Newsletter AAFP adopts new physician workforce policy to counter family physicians shortage... Medicare and Medicaid services propose allowing use of part D data for research initiatives... etc. mark for My Articles similar articles
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. mark for My Articles similar articles
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. mark for My Articles similar articles
Pharmaceutical Executive
September 1, 2013
Shantanu Agrawal
Making Sense of the Sunshine Act: A New Era for Drug Promotion Now that the Sunshine Act's Open Payments spending disclosure program is live, the federal government's lead officer for compliance explains how the new web-based system will work and how US industry, providers, and patients will be better off by making their relationships fully transparent. mark for My Articles similar articles
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). mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
September 2004
Tony Berberabe
Can Physician and Health Plan Get Together Over Guidelines? Physicians are not the only problem. Health plans too often view guidelines as rigid routines rather than flexible aids to good practice. mark for My Articles similar articles
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. mark for My Articles similar articles
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? mark for My Articles similar articles
Pharmaceutical Executive
September 1, 2012
Al Topin
Doctors' Words No Longer Gospel In the digital age, physicians don't call the shots when it comes to healthcare guidance. Marketers must appeal to multiple sources in seeking ways to garner patient adherence and loyalty. mark for My Articles similar articles
Pharmaceutical Executive
March 1, 2013
Al Topin
Less Selling, More Time What can happen when pharmaceutical reps focus on the physician-patient conversation? mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
July 2001
Harry L. Leider
HMOs Need To Share Gains of DM Programs Physicians are more likely to buy in if they see better outcomes -- and financial rewards that go with them... mark for My Articles similar articles