Managed Care - July 2008 - (Page 1) EDITOR’S MEMO Care Editor M A N A G E D Health Care Consumers Really Are Sensitive to Prices By John Marcille sn’t it encouraging to hear more evidence of the success of consumerdirected health care? By which I mean the idea of making members put some skin in the game, as the overused metaphor has it. Just what success do I refer to? Well, there is that report from the Center for Studying Health System Change, which tells us that 20 percent of Americans went without needed medical care last year, most of them blaming high cost. Some employers push those high-deductible “consumer” plans on the stated theory that people will choose more cost-effective care options and will forego unnecessary care. But it stands to reason that they will forego necessary care too, if their out-of-pocket cost is too high. Let’s face it: Health care isn’t cheap, and now neither is gas. Readers of this journal are not exactly economically representative of median America, where folks might have to choose $4.50-agallon oil over $4.50-a-pill maintenance drugs because if they can’t get to work, they can’t buy anything at all. Median (not per-capita) household income was $48,000 in 2006. I don’t have to tell you that means half the families have incomes below $48,000. The New York Times reported that the lead author of the CSHSC study suggested that it wasn’t just high-deductible plans that led to the voluntary denial; it was likely, he said, that the cost of care has finally gotten just too high for a lot of people. Guess I jumped the gun, blaming it on plan designs with high out-of-pocket costs. Or was I just being tongue-in-cheek? You decide. Health plans do what they can to keep a lid on costs, but it ain’t easy. In this issue, we discuss the need to ensure adherence to specialty pharmaceuticals so as to get the most bang for the buck and a Leapfrog initiative on hospital length of stay. But we also take note, in our cover story, of a trend that could be bad for costs — physician-hospital integration — while at the same time offering the prospect of more highly coordinated care. MC JOHN MARCILLE Managing Editor FRANK DIAMOND Associate Editor I TONY BERBERABE Consulting Editor MICHAEL DALZELL Senior Contributing Editor MARGARETANN CROSS Contributing Editors LOLA BUTCHER JOHN CARROLL MAUREEN GLABMAN MARTIN SIPKOFF Design Director PHILIP DENLINGER Group Publisher TIMOTHY P. SEARCH, RPH Director of New Product Development TIMOTHY J. STEZZI Eastern Sales Manager SCOTT MACDONALD Senior Account Manager KENNETH D. WATKINS, III Director of Production Services WANETA PEART Circulation Manager CONTACT E-MAIL ADDRESSES: Editors: editors_mail@managedcaremag.com Circulation: managedcare@icnfull.com Advertising: advertising_info@managedcaremag.com Reprints: reprints_request@managedcaremag.com JACQUELYN OTT Clinical judgment must guide each clinician in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this publication may reflect the professional literature or other clinical sources, or may reflect the clinical experience of the authors, and might not be the same as what is on the approved package insert. Please consult the complete prescribing information for any products mentioned in this publication. MediMedia USA Inc. assumes no liability for the information published herein. MANAGED CARE (ISSN 1062-3388) is published monthly by MediMedia USA, Inc. at 780 Township Line Road, Yardley, PA 19067. This is Volume 17, Issue 7. Phone: (267) 685-2788; fax (267) 685-2966. Send letters to the editor to Frank Diamond, MANAGED CARE, 780 Township Line Road, Yardley, PA 19067. Letters may be edited for length and clarity. Copyright 2008 by MediMedia USA, Inc. All rights reserved under the United States, International, and Pan-American copyright conventions. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, electronic, or otherwise, without the prior written permission of MediMedia USA Inc. The copyright law of the United States governs the making of photocopies or other reproductions of copyrighted material. Subscriptions for individuals or institutions in the U.S.A. are $100 per year, $10 per single copy; elsewhere, $120 per year, $22 per single copy. Inquiries about paid subscriptions: Lisa Gardineer, telephone (267) 685-2789; e-mail: lgardineer@medimedia.com-. Postmaster: Send address changes to MANAGED CARE, PO Box 2019, Langhorne, PA 19067. Periodicals postage paid at Morrisville, PA, and at additional mailing offices. Major articles are reviewed by appropriate members of the editorial advisory board and/or other qualified experts. Opinions are those of the authors and not necessarily those of the institutions that employ the authors, nor of the publisher, editor, or editorial advisory board of MANAGED CARE. JULY 2008 / MANAGED CARE 1
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