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In his state of the union address in April 2004, President George W. Bush called for most Americans to have interoperable electronic health records (EHRs) within 10 years. More than a year after that ambitious pronouncement, business leaders, IT executives, healthcare professionals and average consumers are still debating exactly how that will happen.
In Some Parts of the United States, health plans have observed a growing trend of hospital-based provider groups, such as radiologists, pathologists, anesthesiologists, and emergency room physicians refusing to contract with health benefit plans. When a health plan enrollee seeks services from an in-network hospital in order to obtain lower out-of-pocket costs (for a PPO product) or full benefits (for an HMO product), the enrollee can be hit with a large, unexpected bill from the provider.
Competition Is heating up among insurers, pharmacy benefit managers (PBMs) and health plans as they ready major marketing campaigns to attract and enroll thousands of seniors in Part D Medicare prescription drug plans (PDPs). Insurers are offering hundreds of stand-alone and Medicare Advantage prescription drug plans (MA-PDs) in every region of the country, many promoting lower costs as a way to build market share.
The 2006 introduction of Part D under the Medicare Modernization Act will definitely affect medications targeting osteoporosis, the majority of which are prescribed to those 65 or older.
There also needs to be sufficient access and guidance so the beneficiary can make informed and knowledgeable choices.