Mari Edlin is a frequent contributor to Managed Healthcare Executive. She is based in Sonoma, California.
Just like the rest of healthcare, dental and vision ancillary benefit providers are adopting cost-sharing strategies that offer options to employees but demand more skin in the game. With less financial responsibility on the shoulders of employers, ancillary benefits have become more flexible, varied and are more closely tied to the overall health of individuals, who are assuming more risk for their health.
Research has provided more support for the idea that differences do exist between the sexes. Since 2001, the interest seems to have waned. Called pharmacokinetics, it is the study of what the body does to a drug, not what the drug does to the body.
Insurers are evaluating the costs and benefits of generic testing to determine their level of commitment to the emerging medical discipline.
The times they are a changin'," written and sung by Bob Dylan, was a popular protest song in the 1960s, and those words hold true today in the dynamic healthcare industry. The American industrial nation bred musculoskeletal problems but today's workplace presents new problems-depression and related conditions-the greatest impact on productivity, says Sean Sullivan, president and CEO of the Institute for Health and Productivity Management in Scottsdale, Ariz., and a member of the Managed Healthcare Executive editorial advisory board.
Depressive disorders stand out as a major occupational health issue, and employers are feeling the burden in reduced productivity and higher healthcare costs for their work forces.
WellPoint supports putting gold-standard generics in most drug classes on the first tier.
Through its research correlating copayments with utilization, Express Scripts, a pharmacy benefits manager (PBM) in St. Louis, found that a three-tier structure can control prescription drug costs without causing any unintended consequences, such as visits to the emergency room or hospitalizations.
Workers’ comp pays 74% more than group health for the same drugs, due to lack of control over AWP and limited purchasing power.
Improve medication compliance for all patients
Plans involve pharmacy and physicians to improve medication adherence and continuity
Vouchers, bargains and other marketing teasers inspire members to try less-expensive generics
Knocking down the silos that separate these disciplines enables higher quality care
Educational pregnancy programs targeting minority members and those with risk factors help deliver optimal outcomes
FMCP model urges plans to think outside the cost silo when making formulary decisions
With new coalitions and programs similar to commercial plans, states are keepinga handle on Medicaid drug spending
