Managed Care - November 2008 - (Page 7)

NEWS AND COMMENTARY primary care physicians who accept new patients, if they are forced to wait weeks for an appointment, if they cannot obtain primary care because of its hours or location, or if they perceive care from other providers to be substandard compared with care received in the ED. PCPs report little knowledge of CDHPs ow ready are primary care physicians to talk to patients about cost and quality when high-deductible health plans are involved? A national sample of PCPs suggests that they have limited knowledge and are not ready to advise patients about cost and medical budgeting. Of the 528 respondents to the Robert Wood Johnson Clinical Scholars Program survey, 40 percent of PCPs had CDHP enrollees in their practices. Forty-three percent of physicians reported low knowledge of CDHP cost sharing, and about one-third reported low knowledge of how medical savings accounts function. Overall, physicians with CDHP enrollees in their practices had higher knowledge than physicians without these patients; however, 1 in 4 of these providers reported low knowledge of CDHP cost sharing. H Headlines On Deadline .. . Fifty-seven percent of employers with 500 or more workers are providing wellness programs to their workers. This is up from 49 percent in 2006. The number of smaller employers that offer programs has remained steady the last two years at 16 percent, according to MetLife’s Employee Benefits Trends Study. . .. Hawaii has dropped the only state universal child health care program in the country, just seven months after it was launched. Gov. Linda Lingle’s administration cited budget shortfalls and the availability of other health care options. An administrator at the state’s Department of Human Services said that families were dropping private health coverage so their children could be eligible for the free care. “I don’t believe that was the intent of the plan,” said Kenny Fink, MD. . . . PharmMD is teaming up with HealthSpring to provide medication therapy management services to more than 265,000 of HealthSpring’s members. MTM attempts to prevent medication error, misuse, underuse, and abuse by ensuring that individual patients receive the most appropriate drugs possible. MTM is intended to ferret out duplicate medications and prevent harmful drug interactions. PharmMD is providing the managed care organization with information technology to help monitor pharmacy utilization records. The plan’s pharmacists will be able to better watch for potential drug interactions and for opportunities to optimize a patient’s drug regimens. — Tony Berberabe Knowledge and attitudes Physicians with CDHP enrollees in their practices had more knowledge, in general, about CDHPs High Baseline knowledge before this survey Middle Low 43% 43% 24% 33% 24% 33% 34% 31% 35% 36% 32% 31% CDHPs in general Out-of-pocket costs with CDHPs How money is contributed to medical savings accounts 46% 37% 17% How money is spent from medical savings accounts Impression of CDHPs Favorable Neutral Unfavorable Using CDHPs will decrease .. . 45% 24% 31% 71% Agree Neutral Unfavorable 19% 10% Clinically indicated care Care that is not clinically indicated Source: Mallya G, Pollack CE, Polsky D. Are primary care physicians ready to practice in a consumer-driven environment? Am J Man Care. 2008;14(10):661–668. NOVEMBER 2008 / MANAGED CARE 7

Table of Contents Feed for the Digital Edition of Managed Care - November 2008

Managed Care - November 2008 Editor’s Memo Contents News and Commentary Legislation & Regulation Letters Medication Management Compensation Monitor Do It Yourself for Less Biomarkers Promise, but Do They Deliver? Oncologists Complain About Drug Payment Consider Blood Pressure Self-Monitoring Q&A: Keep Industry in the Game Formulary Files Plan Watch Tomorrow’s Medicine Outlook Respiratory Syncytial Virus Managed Care Considerations Contents Continuing Education Objectives RSV Disease in the Pediatric Population In the Trenches RSV Infection in the Adult Population Health Plan Medical Director Health Plan Pharmacy Director RSV Issues and Solutions Assessment/Evaluation/Certificate Request Post-Test

Managed Care - November 2008

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