Managed Care Calendar
- AAPM 2010 Clinical Meeting
- AMCP 2010 Educational Conference
Poll
Issue
- Issue:May 2010
Lawmakers Continue to Struggle with Doc Fix
Temporarily delaying mandated reimbursement cuts for physicians providing Medicare services has become a routine and recurring event in the US Congress. Since 2002, lawmakers have repeatedly passed legislative stopgaps to forestall reductions in the Medicare Physician Fee Schedule (MPFS) mandated by Medicare’s Sustainable Growth Rate (SGR) formula, but some of the recently enacted pay patches have lasted little more than a month. While lawmakers procrastinate, frustrated doctors continue to advocate a permanent solution, ofte
- Issue:May 2010
Insurers Contemplate New Spending Requirements
Health insurers are considering the financial impact of mandatory medical loss ratios (MLRs) requiring them to spend minimum percentages of the premiums they collect on providing healthcare to customers. Starting in 2011, insurers will have to comply with federally mandated MLRs or provide rebates to consumers based on the amount that spending falls below these minimums. While stakeholders in the insurance industry work with regulators to determine precisely how the MLRs will be calculated and applied, some are taking preemp
- Issue:May 2010
The US Food and Drug Administration between June 14, 1996, and February 26, 2004, approved 6 chemotherapeutic agents for the treatment of colorectal cancer. Two of these drugs, bevacizumab and cetuximab, have been singled out as examples of high-cost/low-value medical care. In previous randomized controlled clinical trials, bevacizumab has been shown to extend median survival time by 3 to 5 months at a cost that can exceed $8000 per month.
Researchers recently conducted a study to compare trends in life expectancy and lifetime medical costs in a population of 4665 Medicare benefi
- Issue:May 2010
In a recent controlled preintervention/postintervention study, researchers found that although Health Resources and Services Administration (HRSA) Health Disparities Collaboratives (HDCs) are known to improve quality of care in community health centers (CHCs), they had minimal effect on racial/ethnic and insurance disparities. The results were published in Archives of Internal Medicine [2010;170(3):279-286].
Publicly supported CHCs are responsible for caring for >15 million Americans, many of whom are members of groups that have previously been documented to receive
- Issue:May 2010
San Diego—Value-based design insurance programs have remained a viable investment strategy even during the latest economic downturn, according to the results of a recent survey.
The survey results and the benefits of value-based design were recently discussed in an educational session at the AMCP meeting. Cynthia Nayer of the Center for Health Value Innovation and Michael Jacobs of Buck Consultants led the presentation.The Center for Health Value Innovation just released the Val
- Issue:May 2010
Actemra (tocilizumab) is an interleukin-6 (IL-6) receptor inhibitor used to treat adults with moderate-to-severe rheumatoid arthritis (RA) who have not adequately responded to or cannot tolerate other approved drug classes for RA. The drug is a humanized monoclonal antibody that works by blocking the action of IL-6, an immune system protein that is overabundant in people with RA.
Tocilizumab is approved for once-a-month intravenous (IV) administration in physicians’ offices, hospitals, and infusion centers, and may be used alone or in combination with methotrexate or other disease-mo - Issue:May 2010
Product News
New Combination Oral Contraceptive
The US Food and Drug Administration (FDA) has approved Natazia, a combination hormonal tablet for use as an oral contraceptive. Natazia contains two female hormones, an estrogen (estradiol valerate) and a progestin (dienogest), and is the first four-phasic oral contraceptive marketed in the United States. Four-phasic refers to the doses of progestin and estrogen varying at 4 times throughout each 28-day treatment cycle. The product is manufactured by Ba
REQUIP XL is an oral dopamine agonist medication for Parkinson’s disease and had demonstrated significant improvement in the symptoms of Parkinson’s disease.
The Role of Immune Function in the Changing Landscape of RRMS Therapies
Gastroesophageal reflux disease (GERD) is an important
managed care health concern because it is one of the most common gastrointestinal (GI) disorders in the United
States. GERD affects nearly 18.6 million Americans, according to a national healthcare database analysis.
Parkinson’s disease (PD) is a progressive
and disabling neurologic disorder. The disease is the most prevalent type of parkinsonism, a clinical syndrome caused by lesions in the basal ganglia, predominantly in the substantia nigra, which produces deficits in motor behavior.
