Managed Care - May 2008 - (Page 4) 20 Gail Wilensky Care Vol. 17, No. 5 May 2008 COVER STORY M A N A G E D Explosive Numbers 20 Think of all the methods that have been used to try to control costs: disease management, pay for performance, consumer-directed health care, formulary tiers. Still, costs keep rising. 39 Reed Tuckson, MD Big Changes for Medicare 29 Moving to a payment system tied to the severity of illness and refusing to pay for hospital-acquired conditions may encourage private payers to do the same. 43 Q&A: Reed Tuckson 39 Chief of medical affairs at UnitedHealth Group, he wants universal coverage — now. “Each night that we continue to debate perfect solutions, people die. . . .” The Versatile PBM Defending RomneyCare 43 46 There is no one-size-fits-all contract. Health insurers should want to deal with PBMs that offer customized approaches and flexibility. John D. Jones, RPh, JD Critics have labeled this Massachusetts program a failure, but policymakers, physicians, and insurers in the state disagree. They point, for instance, to 340,000 formerly uninsured who now have coverage. DEPARTMENTS Editor’s Memo 3 When all else fails? Compensation Monitor 19 More physicians work part-time. Formulary Files 50 Keeping an eye on PDP costs. PlanWatch 51 Aetna caps rollover amount, sees results. Tomorrow’s Medicine 53 Skin glue: Breakthrough for surgeons. Outlook 59 U.S. health inflation not so bad? 46 Jon Kingsdale New Electronic Edition This new edition looks just like the physical magazine. Search through it; use hyperlinks; download to your desktop. www.managedcaremag.com/ nxtbook Viewpoint 8 IT lessons from Canada. Legislation & Regulation 12 Putting therapies to a new test. News and Commentary 14 Tiers worked in retiree plans. Medication Management 17 Behind-the-counter system coming? Visit us online at http://www.managedcaremag.com/ COVER PHOTOGRAPH: ©Chris Collins/CORBIS http://www.managedcaremag.com/nxtbook http://www.managedcaremag.com/ http://www.managedcaremag.com/nxtbook
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