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Urology
Between physicians and payers: Physician executive in dual role seeks to build trust
October 01, 2006
Paul Handel, MD, has enjoyed a long, distinguished career as a physician in Texas, and now he wears two distinctive hats-neither of which is a Stetson.
Built to scale: Ed Sellers leads BlueCross BlueShield of SouthCarolina
May 01, 2006
Every time a new stop light goes up in a growing neighborhood,BlueCross BlueShield of South Carolina (BlueCross) wants to have acustomer within a block of it. This health plan, nested withsubsidiary businesses, has prioritized growth through an aggressivebranching out from its core competencies. Half of its totalbusiness comes from selling products to other healthcareorganizations.
Built to scale: Ed Sellers leads BlueCross BlueShield of SouthCarolina
May 01, 2006
Every time a new stop light goes up in a growing neighborhood,BlueCross BlueShield of South Carolina (BlueCross) wants to have acustomer within a block of it. This health plan, nested withsubsidiary businesses, has prioritized growth through an aggressivebranching out from its core competencies. Half of its totalbusiness comes from selling products to other healthcareorganizations.
Coming to Terms
December 01, 2005
Just mentioning "contract negotiations" can put plans and providers on the defensive or maybe even the offensive. The sometimes-contentious relationship between the two, triggered by the high cost of healthcare and complaints from providers about not being paid enough, escalates while both parties try to come to some kind of agreement.
Enhance efficiencies through shared emergency room data
October 01, 2005
The high cost of emergency department (ED) care is a concern for commercial and government insurers, hospitals, physicians and patients. Two-thirds of EDs operate at full capacity or over capacity, a situation exacerbated by increased ED visits from both insured and uninsured patients. Software applications that automate the ED can help improve patient outcomes and reduce costs. Payer organizations should be aware of four key adoption trends in ED automation.
DM Web site goes beyond national guidelines to include real-world ideas
October 01, 2005
While healthcare is highly competitive from a business perspective, when it comes to the actual delivery of care, everyone is on the same team. The ultimate goal is to provide the best possible care at the lowest possible cost, and that's exactly why the Cleveland Clinic created its Disease Management Project.
Drug advertising guidelines draw criticism
September 01, 2005
Critics contend that DTC promotion boosts medical costs.
Managing the Costs of Injectable Therapies: Do You Have the Right Game Plan? (PDF)
April 01, 2005
About three years ago I asked a large group of health plan executives if they knew how much they spend annually for ?specialty pharmacy? products. Few could respond, and virtually none had launched any efforts to control the then unknown rapid increase in these costs.Today, this is not the case.
On Finance: Costly pain of fibromyalgia can be reduced with holistic treatment
September 01, 2004
Fibromyalgia is real and prevalent, yet many physicians and employers may inadvertently ignore or demean sufferers, not only at the cost of those with the condition, but at the cost of productivity and healthcare expenditures.
Skirmishing continues over drug importing
August 01, 2004
Washington, D.C. - Last month, the House approved legislation that would make it easier for Americans to obtain prescription drugs from Canada and other countries, similar to action it took last year. This time the legislators voted overwhelmingly to add to FDA's 2005 budget bill a provision that blocks FDA from enforcing a ban on drug reimportation. The drug import language is not expected to survive House-Senate negotiations on a final FDA spending bill, but it allows members of Congress to portray themselves as import advocates at election time.
Reader Response to 'ER is a Hit '
December 10, 2003
Our recent "ER is a Hit With Insured Americans" news item stirred up some reader response.
Benchmarking helps attain the delicate balance between cost and quality
September 01, 2003
Data allow MCOs to evalutate their pharmacy services and which drugs should or should not be covered
News & Trends
August 01, 2003
New HEDIS measures for 2004; President&s New Freedom Commission on Mental Health report; The Commonwealth Fund's report on eroding retiree benefits