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Managed Care October 2002	HMO drug formulary access increases for COX-2s Access to Celebrex and Vioxx under HMO drug formularies has increased about 50 percent over the past two years, according to data from MediMedia Information Technologies' Formulary Compass.
Managed Care November 2002	Flu season: Most HMO formularies cover Tamiflu, Relenza As the influenza season approaches, managed care patient access to Tamiflu (oseltamivir) from Roche Laboratories and Relenza (zanamivir) from GlaxoSmithKline, the two medications indicated for influenza, looks relatively open.
Managed Care August 2005	Dronabinol Can't Replace Medical Marijuana Controversy regarding Marinol revolves around it's synthesized, single compound and the time it tales to become effective.
Managed Care March 2004	More State Medicaid Programs Use Preferred Drug Lists To Manage Costs Medicaid, enacted in 1965, is currently costing over $200 billion per year. With rapidly rising health care costs, including prescription drugs, state Medicaid budgets are feeling the strain. Here's what they're trying to do to manage.
Managed Care March 2005	ED drugs covered, but managed care unmoved Health care insurers account for the coverage of erectile dysfunction drugs.
Managed Care February 2006	Managed Care Offered to More Medicaid Enrollees A chart illustrates the percentage of medicaid enrollees in managed care, for the years 1996 to 2004.
Managed Care November 2004	Tiered Formularies Open the Potential for Lack of Access to Needed Drugs Tiered formularies that have additional incentives for preferred medications could create the potential for therapeutic compromises.
Managed Care June 2003	For-profit, not-for-profit enrollment holding about steady While HMOs seemed to be losing enrollees to PPOs, the ratio of enrollees in for-profit and not-for-profit HMOs stabilized in the late 1990s, according to data collected by the Centers for Medicare and Medicaid Services.
Managed Care October 2005 Martin Sipkoff	Restrictive Formularies May Be Contagious It's the law of unintended consequences: A restrictive drug formulary maintained by a health plan may influence how physicians treat patients unaffiliated with that plan. What does this mean to managed care?
Managed Care March 2000	Three-tier drug copayments in; closed formularies on way out?
Registered Rep. September 18, 2013 Kevin McKinley	Having Money and Getting Medicaid Clients who want to have both their money and Medicaid may want to purchase a specific type of long-term care insurance known as a "partnership" policy, currently available to residents in 31 states.
Managed Care August 2002	24 States Hope Pharmacy Plus Helps Medicaid Twenty-four states may gamble that providing a prescription drug program to low-income elderly who do not qualify for Medicaid could save them money in the long run.
Managed Care February 2007	Employer-Sponsored Insurance Coverage Rates Falling A new report says that that 61 percent of non-elderly Americans had employer-sponsored insurance in 2004, compared to 66 percent in 2000.
Managed Care April 2005 John Carroll	Can Managed Care Programs Rein in Medicaid's Runaway Budgets? Cadillac or Yugo care for the poor? Fee-for-service or managed care? The states have a lot on their minds as the Medicaid monster grows and grows.
Managed Care July 2002	CBO Weighs Effect of Growing Deficit on Fed Programs Health care programs such as Medicare and Medicaid figure to suffer, thanks to a growing federal budget deficit, according to a report by the Congressional Budget Office.
Managed Care November 1999 Richard Hamer	Goals 2000: For HMOs: Administrative Retooling For MDs: Managerial Competency ...While HMOs retrench, physicians need to become more constructive participants....
Managed Care August 2002 Madeleine A. Estabrook	Regulators Take More Interest In Role of PBMs in Health Care In a highly regulated industry such as health care, it is just a matter of time before every component of the industry comes under scrutiny and review. Pharmacy benefit managers are taking center stage now.
Managed Care September 1999 Frank Diamond Senior Editor	Florida Medicaid Moves Toward Direct Contracting Florida will soon test a program that could provide competition for HMOs serving the Medicaid population. Other states are watching.
Salon.com October 21, 1999 Dena Bunis	Uninsured children A new report says there are still too many kids without health coverage.
Managed Care April 2004	Medicaid DM To Get Boost From CMS The federal government plans to give Medicaid disease management a lift by matching the money states pay to run such programs.
Pharmaceutical Executive May 1, 2011 Mason Tenaglia	Out of Control The pharmaceutical industry needs to use new and better data to accurately measure how much it is willing to invest in avoiding plan control.
Managed Care July 2006	Education Concerns Push Back Florida's Medicaid Experiment The greatly anticipated meeting between Medicaid and managed care that's expected to take place in Florida has been delayed.
Managed Care July 2004 Martin Sipkoff	Managed Medicaid Business Might Be Worth the Difficulties Financial, regulatory, and access problems continue. Still, this remains a growth industry and some have found a way to profit.
Managed Care November 2004 Tony Berberabe	Military Brings Order To Formulary System Congress told the Department of Defense to create a uniform formulary for all the services, and cover all FDA-approved drugs.
Managed Care June 2002 Jeffry R. Ellis	Third-Party Payers Don't Realize Burdens Placed on Pharmacists PBMs and HMOs, by imposing a workload that doesn't allow enough time for needed functions, seem to want pharmacists to fail, this author asserts.
Managed Care August 2000 Carey Lee Straetz	Managing Medicaid Rolls Often State-by-State Affair Despite the strong economy, Medicaid enrollment may be slowly rising after a three-year decline. The challenges for serving this population are huge.
Managed Care May 2001	Old Ideas About Formulary Structure Gone as Humana Tests 4-Tier Model Humana is phasing in a four-tier formulary that categorizes prescription drugs by costs, rather than generic or brand status. The higher the drug's acquisition cost -- regardless of whether it's a branded or generic product -- the higher the tier it lands in...
Managed Care May 2002 Sharon Baker	Self-Funded HMOs on the Rise Escalating premiums, changing attitudes play a role in employers' decision to take on the same thing that burned many physicians: financial risk
Managed Care November 2002 John Carroll	Drug Companies Crying Foul Over Medicaid's Formulary Push With states' preferred drug lists spreading like a prairie wildfire, the manufacturers have mounted a furious legislative counterattack, funding grass roots campaigns aimed at fanning the opposition in state legislatures even as they wage a legal war in state and federal courts.
Registered Rep. March 1, 2006 Janet Arrowood	The Medicare and Medicaid Minefield As the population ages and life expectancy rises, so does the likelihood that more people will be needing long-term care and your financial advisory clients should know the hard facts about paying for it, because the costs can be staggering.
Managed Care December 2006	Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.
Managed Care October 2001	CMS Defends Plan To Let States Tailor Medicaid Benefits Centers for Medicare and Medicaid Services Administrator Thomas Scully has defended the Bush administration's plan to allow states to opt out of mandatory Medicaid-coverage requirements...
Managed Care August 2004 Martin Sipkoff	Bad Tiered Formulary Designs Yield Poor Outcomes, High Cost Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
Managed Care April 2002	More Than Just 'Chipping' Away at Problem of Uninsured Children CHIP (the Children's Health Insurance Program) continues to grow by leaps and bounds. About 4.6 million children in the U.S. received coverage through CHIP in fiscal year 2001. That's an increase of 38 percent from fiscal year 2000...
Financial Planning September 1, 2008 Donald Jay Korn	Pleading Poverty Few things can play havoc with a thoughtful financial plan as surely as a long stay in a nursing home. Therefore, "Medicaid planning" has become a prime concern for many seniors and their younger relatives.
Investment Advisor March 2006 Elizabeth Festa	Incentives for Long-Term Care New long-term care partnership programs, which are active in four states, now provide private LTC insurance with special access to Medicaid for those exhausting their insurance benefits.
Managed Care November 2002	Tiered formularies: Giving employees more responsibility Experts who say that educating consumers will be the next method used to curb escalating health care costs often point to the success of tiered formularies, which have made patients more aware of the costs of medications.
Managed Care August 2000	With Cost Study, Group Argues For OTC Benefit A study by HECON Associates, a Maryland-based market research group, supports the claim that when prescription drugs become available over the counter, consumers face increased out-of-pocket costs.
InternetNews June 27, 2006 Michael Hickins	Hospital, HMO Ratings 'Open' to Public New York State adopts online scorecards allowing employers and consumers to review local hospitals and HMOs.
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care September 2004	Headlines On Deadline ... The IRS has given health insurers extra time... HMOs now have more than... Employer-sponsored coverage seems to be eroding...
Financial Planning February 1, 2005 DeFrancesco & Flory	The Golden Years? As this country's baby boomers get closer to retirement, long-term care (LTC) will only grow in importance. Medicaid annuities may help clients preserve their assets, even if they're already in a nursing home.
Managed Care January 2007	Headlines on Deadline ... State budgets got an unexpected gift last year... Mortality rates for hospitals ranked high... It looks likely that Massachusetts Gov. Mitt Romney will run for president... etc.
Managed Care February 2002 Bob Carlson	Proposal To Regulate Formularies Draws Sharp Difference of Opinion The National Association of Insurance Commissioners has spent two years developing a model. Drug companies like it; health plans don't...
Managed Care November 2000	For first time ever, HMO enrollment drops in 1999 National HMO enrollment fell by 400,000 last year, from its all-time high of 81.3 million. For at least two years, a wider array of managed care products and an ever-smaller pool of people still covered under indemnity plans slowed the rate of HMO enrollment growth...
Managed Care February 2007	Managed Care Outlook Coverage for children leads policy debate.
Managed Care December 2001	CMS Medicaid Managed Care Proposal Under Close Scrutiny Bioterrorism. Medicaid managed care plans. No link between them? Guess again. It all has to do with how proposed Medicaid regulations would affect patients' rights and funding for Medicaid programs ranging from nursing home care to emergency rooms...
Managed Care July 2000	Changing physicians: Why they do it More than 1 in 8 people changed their personal physician or other primary provider of health care last year. For people enrolled in HMOs, quality of care -- not something related to coverage -- was the number one impetus for switching providers.
Managed Care July 2000	Are Gatekeepers Failing To Control Specialty Costs? The importance of a gatekeeper in keeping costs down has been challenged again -- this time in a study that compares physician utilization for HMOs and point-of-service plans.
Managed Care September 2005	HMO Profits up, But at a Much Slower Rate Overall, the HMOs' profits increased 10.7 percent in 2004, according to data collected from 515 managed care organizations.