News

This month keep an eye out for the National Association of Insurance Commissioners recommendations to the Department of Health and Human Services on how health insurers might calculate their MLRs to satisfy the new regulations.

How can plans know they're getting the most value for their money in disease management and wellness programs?

The Patient Protection and Care Act will allow health insurance coverage through state-based health insurance exchanges, expand Medicaid eligibility, and subsidize insurance premiums, all of which involve state implementation.

It's likely that most major health insurers will participate in the insurance exchanges that must be up and running in each state by 2014, according to experts.

Although the most revolutionary health reform provisions do not go into effect until 2014, insurers and payers are scurrying to implement a number of big changes required this year.

People over the age of 80 is the fastest-growing population sement in the United States, and they are also the most susceptible to falling through the cracks in the healthcare system.

Pamela Morris, president and CEO of Dayton-Ohio-based CareSource is operating the nation's fourth-largest Medicaid managed care plan in the recession-plagued state of Ohio.

While not a panacea, emerging financial tools that facilitate members' interaction with the healthcare system--such as online treatment-cost estimators--hold the potential to become a truly effective technology that will help improve those problem areas.

As healthcare moves from a broader clinical mentality to more personalized, tailor medicine, pharmacogenomics is emerging as a best-practice therapy.

A recent national sampling of 34 insurers' EOBs by DALBAR, a third-party communications evaluation firm, gave 68% of the EOB statements it analyzed a failing grade.

It is no surprise that the passage of the Patient Protection and Affordable Care Act has sparked several legal challenges. States already have insurance laws and regulations. But what happens to these now?

Despite advances in behavioral health management, managed care persistenently incurs significant costs for members with a diagnosis of substance dependence.

White House staffers are praising plans that cover young adults before the September deadline.

California voters, regardless of their political party affiliation or income level, are worried about and feel unprepared for the costs of long-term care, according to a new poll from The SCAN Foundation and the UCLA Center for Health Policy Research.

The American College of Physicians' High-Value, Cost-Conscious Care initiative will assess benefits, harms, and costs of diagnostic tests and treatments for various diseases to determine whether they provide good value.

At the Managed Care Executive Group?s (MCEG) recent annual forum, the group released its annual top 10 issues list. This year the Top Ten is dominated by the role of government.

Low-dose oral colchicine is just as effective as high-dose colchicine in reducing pain associated with early acute gout flare, but with a safety profile statistically indistinguishable from placebo, according to a study published in the April issue of Arthritis & Rheumatism, the official journal of the American College of Rheumatology.

Anticonvulsant agents have important therapeutic benefits. However, both the healthcare provider and patient need to remain cognizant of associated risks, according to results of a study published in the April 13, 2010, edition of the Journal of the American Medical Association.

The Board of Trustees of the Foundation for Managed Care Pharmacy (FMCP), the educational and philanthropic arm of the Academy of Managed Care Pharmacy (AMCP), announced the winners in the 10th Annual AMCP/FMCP National Student Pharmacist Pharmacy & Therapeutics (P&T) Competition, and FMCP Best Student Pharmacist and Best Resident or Fellow Poster Contests.

Patients with coronary heart disease (CHD) or CHD equivalent on stable statin monotherapy treated with the addition of extended-release niacin have significant decreases in carotid intima-media thickness compared with those who had ezetimibe added to their stable statin treatment, according to a study published online April 14 in the Journal of the American College of Cardiology, as reported by HealthDay News.

Of 10 antiepileptic drugs (AEDs) studied in older adults with epilepsy, lamotrigine closely followed by levetiracetam is the most effective, as measured by 12-month retention and freedom from seizures, while oxcarbazepine is consistently less effective than other AEDs, according to research published in the April issue of the Archives of Neurology, as reported by HealthDay News.

In older patients treated with warfarin, the use of cotrimoxazole is associated with a higher risk of upper gastrointestinal tract hemorrhage than other common antibiotics, according to research published in the April 12 issue of the Archives of Internal Medicine, as reported by HealthDay News.

Liraglutide offered superior glycemic control to sitagliptin in patients with type 2 diabetes who had inadequate glycemic control on metformin, according to a recent report in The Lancet.

Since Congress passed healthcare reform legislation in March, Formulary has continued to ask for your feedback. Here is your response.

Each pharmacologic management strategy for atrial fibrillation has limitations and more research is needed to determine which agents are equally effective, yet safer alternatives. Providing thromboprophylaxis to decrease risk of ischemic stroke is a well-validated approach. However, deciding between rhythm or rate control may not be as straightforward.

Despite known contamination with porcine circovirus type 1, an FDA advisory panel recently agreed that Rotarix (GlaxoSmithKline) and RotaTeq (Merck), two approved vaccines to prevent rotavirus infection, should continue to be used.

Agents in late-stage development for the treatment of epilepsy/seizure disorders.

FDA Amendments Act of 2007 included provisions for sponsors to submit Risk Evaluation and Mitigation Strategies for select pharmaceuticals, if FDA considered it necessary to ensure that its benefits outweigh its risks.

On March 10, 2010, FDA announced that its review of data requested in June 2008 from all bisphosphonate drug manufacturers did not suggest an increased risk of subtrochanteric femur fractures (bone breaks just below the hip) in those receiving oral bisphosphonates.

Chemoprevention with dutasteride (a 5-alpha reductase inhibitor or 5-ARI), given at a dose of 0.5 mg daily, reduced the risk of incident prostate cancer detected on biopsy and improved outcomes related to benign prostatic hyperplasia, according to the results published in the April 1, 2010, edition of the New England Journal of Medicine.