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Health Understood

Health literacy is the next frontier in effective delivery.

Industrial Revolution

George Halvorson helps to bring Kaiser Permanente to the leading edge of healthcare's own industrial revolution with a massive new EMR system.

New York Attorney General Eliot Spitzer recently pursued investigations focused on a common industry practice utilized by insurers and the brokers that represent corporate buyers of commercial insurance. At issue is whether bids are being rigged, prices fixed, and whether brokers are steering business to insurers that pay them the highest fees without getting the best deal for their corporate clients.

The National Inventors Hall of Fame is located in Akron, Ohio, about 45 minutes from the MANAGED HEALTHCARE EXECUTIVE offices. It's interesting how many of the modern day Hall of Fame inductees are researchers who were honored for their discoveries in medicine, while historical creators offered more electronic or industrial solutions.

Chronic obstructive pulmonary disease (COPD) is a disease state characterized by the progressive development of airflow limitation that is not fully reversible. The airflow limitation is associated with an abnormal inflammatory response of the lungs to noxious particles or gases. It affects approximately 15 million Americans and is associated with high morbidity and mortality. Previously, pharmacologic therapeutic options were limited by relatively short durations of action in the first-line medications and limited efficacy data and/or a high rate of adverse effects in the second-line medications. Today, there are several new and emerging medications to treat this disease state, and new guidelines have been published for disease management. This review examines current therapeutic options, compares efficacy data, and highlights the recommendations from international guidelines.

Nebivolol is a beta-blocker under FDA review for the treatment of hypertension. Nebivolol has unique pharmacologic properties, including high specificity for the beta-1 receptor and a nitric oxide-mediated vasodilatory effect. The agent provides significant blood pressure reduction from baseline values and as compared to placebo. Clinical trials have demonstrated that nebivolol reduces blood pressure similarly to atenolol, bisoprolol, amlodipine, nifedipine, lisinopril, and hydrochlorothiazide. The tolerability of nebivolol is similar to or better than that of these agents. If approved, nebivolol would likely be a viable alternative therapy for hypertension; however, additional studies are needed in patients with heart failure and coronary artery disease.

Suit alleges FDA overstepped jurisdiction in regulating compounding pharmacies; Report lists steps to improve product quality regulatory system; ASHP, AMCP recommend criteria for Medicare formulary design, formulary decision-maker responsibilities; Illinois, Wisconsin specify safeguards, provisions in state-sponsored WWW prescription drug pharmacy

In 2001, with annual healthcare inflation in the double-digits nationwide, Humana CEO Michael McCallister formulated the plan's new strategy to put more information and choice in the hands of employees and healthcare consumers.

The Big 3

PHCS President and CEO Joe Driscoll takes on healthcare's Big 3 with a proprietary PPO network.

The Big 3

PHCS President and CEO Joe Driscoll takes on healthcare's Big 3 with a proprietary PPO network.

For the past several years, non-profit health plans and insurers have been converting to for-profit corporations (or have been acquired by for-profit enterprises) in an effort to gain access to capital markets, to expand their service area, and/or to add to their product lines. In most states, the Blue Cross Blue Shield plans are no longer non-profit.

There has been a nationwide increase in the incidence of vancomycin-resistant Enterococcus (VRE) reported over the last decade and a half. The heightened concern caused by VRE and the possibility of vancomycin resistance gene transfer to other gram positive organisms, especially methicillin-resistant Staphylococcus aureus (MRSA), led the Centers for Disease Control and Prevention (CDC) and the Hospital Infection Control Practices Advisory Committee (HICPAC) to publish recommendations for the prevention and control of vancomycin resistance. However, in 2002, the first documented case of vancomycin-resistant S aureus (VRSA) was reported in Michigan in an immunocompromised patient with a history of diabetes, peripheral vascular disease, and renal failure. Since then, 2 other cases have been reported: 1 in Pennsylvania in October 2002 and 1 in New York in March 2004. The limited availability of effective antimicrobial agents against vancomycin-resistant strains of Enterococcus and Staphylococcus species and the morbidity, mortality, and cost associated with resistance represent serious reasons for concern. This article presents a general overview of the current literature on the prevention and control of vancomycin resistance and a review of potential antimicrobial agents used in the treatment of VRE, vancomycin intermediate S aureus (VISA), and VRSA infections.

Secondary hyperparathyroidism is a common sequelae of chronic kidney disease. Treatment of this condition with traditional agents such as phosphate binders and vitamin D analogs is often complicated by the development of hypercalcemia and hyperphosphatemia. Cinacalcet (Sensipar, Amgen) is the first agent in a new class of drugs called calcimimetics. The agent sensitizes the calcium-sensing receptors in the parathyroid gland to extracellular calcium and directly lowers arathyroid hormone levels. Cinacalcet is FDA-approved for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis. In this patient population, cinacalcet reduces plasma intact parathyroid hormone (iPTH) levels, serum calcium and phosphorus levels, and the calcium-phosphorus product without associated hypercalcemia and hyperphosphatemia. Cinacalcet appears to be well-tolerated, with nausea, vomiting, and hypocalcemia as the main adverse events. The drug is also approved for the treatment of hypercalcemia in patients with parathyroid carcinoma and holds promise for the treatment of primary hyperparathyroidism.

FDA combats illegal WWW drug sales; Electronic database allows greater public access to studies; ‘Roadmap’ developed to prepare for and respond to pandemic; Government seeks posting of clinical trial results online; Purchasing pools yield more options, savings for states; New efforts to increase antimicrobial research gain momentum

Since the mid-1990s, most U.S. industries have begun to outsource inbound customer care as a cost control measure. The experience and sophistication of many outsourced service providers allow clients to achieve substantial cost savings, including minimizing capital expenditure for new technologies while maintaining the same or improved service levels.