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Managed Care April 2004 MargaretAnn Cross	Medical Directors Find Themselves Working More Closely With Payers As large companies become more demanding of health plans, clinical executives are increasingly being relied on to provide advice and expertise.
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.
Managed Care November 2004 MargaretAnn Cross	Accrediting Agencies Turn Attention To Consumer-Directed Health Plans If employers make decisions based on United Regional Health Care Foundation's and National Committee for Quality Assurance's rating of traditional managed care plans, shouldn't they want similar ratings of consumer-directed health plans?
Managed Care May 2004 MargaretAnn Cross	Will Providers Seek New Contracts As Consumer-Directed Plans Grow? Although plans are not restructuring fee schedules in consumer-directed health plans, providers think their agreements need fine-tuning.
Managed Care August 2004 Marilyn Bydalek	Navigating the Personnel Rapids: What They Never Taught You in Med School Physicians who make the move to the administrative side find a lot of tough decisions waiting for them.
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?
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 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 2005 MargaretAnn Cross	Consumer-Directed and Home-Brewed Regional health plans and small HMOs coming late to the consumer-directed health plan market haven't missed out -- yet.
Managed Care July 2003	Where physician executives can expect the best pay Medical directors of single-specialty groups lead pack
Managed Care May 2003 MargaretAnn Cross	Physicians in Large Corporations Take on More Influential Roles Businesses are relying on doctors to direct the health benefit. They often work directly with plans to keep workers healthy -- and at their posts.
Managed Care May 2003 Martin Sipkoff	Working Together on the Medical Side Partly because of employers' demands, health plans are starting to cooperate in ways that improve care.
Managed Care November 2007 MargaretAnn Cross	The Evolving Health Plan The consumer-directed health care model isn't taking the country by storm, but its innovations are influencing other coverage designs.
Managed Care August 2002	Life may be better without a white coat Are clinical duties holding you back from a bigger paycheck? If you're a group practice medical director, maybe so.
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 July 2005 Stanley Hochberg	Insurers Can No Longer Afford Not To Share Some Data Pay-for-performance programs imply improved patient care, but are frustrated by fragmented data collection and reporting systems.
Managed Care December 2005	Health Plan Medical Directors Doing Well Medical directors at health plans saw a 7.2% rise in mean direct compensation from 2003 to 2005.
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 June 2006 Amanda Brower	Retail Medical Clinics Draw Patients & Payers A growing number of health plans are adding retail health clinics to their networks and are realizing savings. But physicians voice concern over the quality of care provided to patients.
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 April 2006 Tony Berberabe	Insurers Rely on Providers To Screen for Depression With access only to claims data, health plans strive to promote the importance of depression screening to their providers.
Managed Care July 2005 Tony Berberabe	Change in Thinking For Pharmacy Benefits in CDHP The difference between the pharmacy benefit in a consumer-directed health plan and a traditional health plan is greater generic drug utilization.
Managed Care October 2004	Consumer-Directed Insurance Plans Problematic for Patients, Docs, HMOs New studies are finding wide variations of cost and quality across hospitals and physicians, yet few private insurers, managed care plans, or public programs reward superior quality or efficiency.
Managed Care August 2007	Consumer-Directed Health Plans: Built to Last or Designed to Fail? A point-counterpoint debate about the effect of CDHPs on overall health and health care costs.
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 February 2006 Lola Butcher	Consumer-Directed Health Pains Two studies suggest that consumer-directed health care may not be a long-term method for controlling health care costs.
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 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 December 2005 MargaretAnn Cross	The Ethical Way In a Season of Change Advancing technologies and new coverage designs are creating opportunities -- and obligations -- for health plan medical directors.
Managed Care November 2005 MargaretAnn Cross	Health Plans by Design, Not by Default Fortune 500 employers are ready to shed old benefit models for "managed consumerism".
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 October 2007	Data on Quality Lacking for Docs A new report says that insurers are better at providing quality information about hospitals than about physicians.
Managed Care November 2000 Bob Carlson	E-Health's Greener Pastures The trend is unmistakable: Physician executives are leaving their high-pressure, high-paying jobs at health plans, and are starting from scratch in the nascent e-health industry. The lure? A chance to leave their mark on something...
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 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 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 January 2006 Maureen Glabman	What Doctors Don't Know About the New Plan Designs Physicians are fairly ignorant of what consumer-directed health care will mean to them in terms of relations with patients and health plans.
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.
Managed Care March 2004 MargaretAnn Cross	Consumer-Directed Plans Begin Measuring Patient Satisfaction Initial results are promising. Employees turn toward preventive medicine and away from expensive drug therapies.
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 February 2008	Women Increasingly Fill Medical Director Role Women hold a 30 percent greater share of physician executive jobs than they did 10 years ago.
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.
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 2007	A Conversation With Emad Rizk, MD: Disease Management Beyond the Call Center The man who heads McKesson Health Solutions, the third largest disease management program in the country, says it's time to roll out a new model.
Managed Care May 2007 Lola Butcher	Massive Databases Under Construction Insurers and employers are busily compiling databases to control costs and improve care, but physicians are laying claim to the data.
Insurance & Technology September 16, 2005 Katherine Burger	Educating Consumers A truly technology-enabled offering, the idea behind consumer-directed healthcare is that everyone benefits when consumers have more information.
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.
Managed Care December 2001 Alan G. Adler	Executive Coach Helps Physician Adjust to Life as Medical Director The skills that had served me so well in my medical practice didn't help me much in the managed care business world...
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 June 2004 Tony Berberabe	Welcome to the Brave, New (Electronic) World, Doctor WellPoint is providing free handheld or even desktop computers in an effort toward minimizing medication errors. Will docs finally abandon pen and pad?