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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. |
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. |
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? |
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. |
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 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 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 |
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. |
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. |
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. |
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 |
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? |
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. |
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. |
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. |
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. |
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. |
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 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. |
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 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. |
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. |
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 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.... |
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. |
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. |
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. |
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. |
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? |
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? |
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. |
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? |
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. |
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 |
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. |
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. |
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. |
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. |
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 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. |
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. |
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). |
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 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. |
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 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? |
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. |
Pharmaceutical Executive March 1, 2013 Al Topin |
Less Selling, More Time What can happen when pharmaceutical reps focus on the physician-patient conversation? |
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 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... |