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Managed Care June 2001 Frank Diamond	HMO/Physician Strain Creates Invisible Costs Perhaps goodwill is too much to ask for. However, peaceful coexistence can certainly help all players reach their mutual goal -- a smooth relationship that helps to get the job done...
Managed Care July 2000	Lee N. Newcomer joins Vivius The former senior VP for health policy at UnitedHealth Group joins a company that aims to shift power from HMOs to patients and physicians.
Managed Care May 2000 Frank Diamond Senior Editor	Medical Director: A Typical Day Requires Both Strength and Tact Ruling on queries from phone banks, working to end hospital errors, meeting with disgruntled physicians: Does any of this sound familiar?
Managed Care September 2000	Interview: Peter Boland Will the electronic revolution overthrow managed care? Not necessarily, but it may help define a new role for MCOs not far in the future...
Managed Care October 2000 Maureen Glabman	Giving Some Ground to Physicians Helped Turn Health System Around One hospital system accepted the general wisdom a few years ago by acquiring physician practices. Now it bucks the new wisdom by holding on to them...
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 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...
Managed Care April 2000 Karen L. Trespacz, J.D.	League of Their Own: What Makes a Winning IPA? In a familiar cartoon, a professor writes long, learned equations on a blackboard. To connect the profundities on either end, he writes in the middle, "Then a miracle occurs." IPAs, done well, are the miracles that connect the ends of health care.
Managed Care July 2000 John Carroll	Electronic Medical Records: If Not Now, When? The technology's been around, but early participants often were burned. New Internet-based products threaten to turn nonbelievers into yesterday's news.
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 February 2002 Bob Carlson	Why You Should Care About Improving Clinical Practice Research on quality of care began over 30 years ago. Pages and pages document recent evidence of underuse, overuse, and misuse of resources. Yet only now does change appear imminent, thanks to a growing cadre of passionate reformers who preach clinical practice improvement...
Managed Care July 2001 Maureen Glabman	Provider Shortage Puts HMOs In Bind Increasing demand for physicians and physician extenders is starting to strain the system. To a large extent, this is unexpected bitter fruit of managed care's labor...
Managed Care November 1999 Peter I. Juhn, M.D.	An Evidence-Based Approach To Care Depends on All Parties -- Physicians Included ...transforming the delivery of care into a systematic approach that is based on the best medical evidence -- is dependent on more than just laying out the rules...
Managed Care September 2000 Frank Diamond	'New' Aetna and Kaiser Face Future The biggest for-profit and not-for-profit MCOs have been through rough times recently. How have their corporate cultures changed?
Managed Care November 2005 Frank Diamond	Physicians and Plans Can Get Along Hill Physicians Medical Group, one of the largest IPAs in the country, has learned to deliver what managed care plans want
Managed Care April 2000 Michael D. Dalzell	Not-for-Profit Group of Plans Goes After Medicine's Holy Grail Demonstrating long-term health improvement for specific populations is one of managed care's biggest unrealized goals. One group thinks it has the formula.
Managed Care October 2005 Bob Carlson	What Docs Hate Most About Plans Some insurers seem to have a knack for irritating their network physicians. The list is long, but five categories of irritants seem to recur most often.
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.
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.
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
Managed Care October 2005 MargaretAnn Cross	Just How Will CDHC Change Your Job? Medical directors are charged with many of the tasks that could help members make the most of consumer-directed health plans.
Managed Care September 2001 Michael D. Dalzell	Where Will Health Plans Find The Next Generation of Savings? The industry realizes that it needs to get creative -- or perish, at least in the form it has taken. Employers won't stand long for double-digit premium hikes. With much of the fat already wrung out of care delivery, where will health plans find that next generation of cost savings?
Managed Care November 1999 Karen Ignagni	Health Plans Will Use New Tools To Help Physicians Practice Better For the first time, plans are in a position to work with physicians to improve outcomes, efficiency, and patient safety....
Insurance & Technology August 18, 2010 Nathan Golia	Insurers Take Lead in EHR Implementation With guidelines for meaningful use of electronic health records established, health carriers expect IT improvements on the provider side to lower healthcare costs by reducing care redundancies and readmissions.
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.
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 March 2004 John Carroll	Narrow Networks' Broader Vision Throughout the late 1990s, the fashion in managed care networks was bigger and bigger. These days, though, health plans around the country have begun sizing up so-called narrow networks once again.
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 August 2000 Bob Carlson	'All Products' Clauses Fade From Physician Contracts All-products provisions in health plan provider contracts are slowly being negotiated, legislated, and regulated out of existence. They are now illegal in at least four states; legislation is pending in several others.
Insurance & Technology August 9, 2010 Nathan Golia	Humana, Athenahealth Partner to Spur EHR Adoption The health insurer joins a growing list of peers providing financial or other incentives to providers to adopt electronic health records.
Managed Care December 2003 Frank Diamond	Dr. Do-Good and Mr. Bottom-Line How medical directors reconcile the contradictory demands of physician and executive roles.
Managed Care May 2001 Jack McCain	Use of Hospitalists: Another Case of 'May' vs. 'Must' Despite a movement to ban mandatory use of these physicians, their numbers and influence are rising as their roles become better understood...
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 January 2002 Ed Rabinowitz	When Physicians' Skills Fail, Collaboration Beats Punishment New programs hold promise for rehabilitating sound physicians who have, for any number of reasons, lost some of the skills they started with...
Managed Care May 2001 Michael D. Dalzell	Powerful Opportunities For Good and Greed Genetic advances could spawn incredible improvements in health care. Given public demand, they also pose what may be unmanageable issues of resource use...
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 December 2005 Ricardo Guggenheim	Putting EBM To Work (Easier Said Than Done) Through widespread implementation of evidence-based medicine, the United States has its best chance of erasing the variations in care that currently extract such huge costs -- both human and financial -- from the health care system.
Managed Care November 2000 Jeffrey J. Denning	How's Your Office Manager Doing? Don't Let Question Just Hang There Every worker needs a performance review at least once a year. So, who reviews the reviewer? You do...
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 August 2001	In Calif., Bonuses Based on Quality, Not Cost Savings Blue Cross of California has decided to move away from the traditional managed care incentive of rewarding physicians for controlling medical costs, and instead will implement a program in which physicians receive bonuses for quality of care and patient satisfaction...
Managed Care April 2004 Martin Sipkoff	Plans Go Directly to Patients, Describing Treatment Options HMOs are developing programs that encourage patients to question their physicians about their treatment options. Doctors are wary.
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 May 2000 John Carroll	Internet on Center Stage At Technology Conference Some pretty amazing stuff was on display in Dallas. Where were those most-sought-after potential buyers -- physicians?
Pharmaceutical Executive October 1, 2011	Arming up for the Digital Revolution As a longtime advocate of new approaches to meeting customer needs in pharma, Martin Wygod sees the biggest change as the coming growth of digital platforms as the principal source of information and communication in healthcare.
Managed Care December 2002 Patrick Mullen	Placing Faith in Technology To Improve Members' Choices Not many companies' organizational charts list a 'chief innovation officer.' At Humana, it brings visibility to a high-tech strategy for reducing care fragmentation.
CIO September 23, 2009 Kim S. Nash	Booster Shot for E-Health How federal stimulus spending will impact the rollout of electronic medical records.
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 March 2001 Mark D. Abruzzo	'Final' Stark Regulations Still a Work in Progress The Stark Law generally prohibits physicians from referring Medicare patients for certain designated health services to entities with which the physician (or immediate family members) has a financial relationship...
Managed Care May 2000	Texas-Aetna Incentives Settlement Worries Some Capitated Physicians If the Texas deal ignites a trend away from the use of incentives to keep utilization down, then some capitated physicians worry it will put them in a tight spot.
Managed Care August 2001 John Carroll	Info on Questionable Physicians Languishes in National Data Bank A clearinghouse was created that stores details about malpractice suits and disciplinary actions. So how come HMOs don't use it?