Managed Care - February 2009 - (Page 1) EDITOR’S MEMO Care Editor M A N A G E D Lawsuits Track New Flare-ups In Insurer/Doctor Relationship By John Marcille here’s a lot about technology in this issue. A story on page 21 examines how health plans are dealing with the genomics revolution. Turn to page 26 and read about some amazing patient-monitoring systems that promise a bright future for disease management. Then flip to page 36 and get a glimpse at how information technology might at last foster greater cooperation between health plans and provider networks. I say “might” because I am a realist and so is the author of the page 36 article, Emad Rizk, MD. He cautions: “I am fond of saying that changes in health care come slowly because too many of us think we must boil the ocean before we can drink the water.” I have been covering the managed care industry for about 17 years now and every once in a while I’ll edit a piece on just why health plans and doctors are tired of all the fussing and would just like to get along. Then the real world bursts in. That’s as good a transition as any to our cover story on page 14. Contributing Editor Maureen Glabman lays out how health plans have more and more become the targets of litigation by providers, primarily physicians. It seems that doctors have much less compunction about going after a health insurance plan if they can do so as mostly anonymous participants in a classaction lawsuit. On page 20, Maureen outlines how insurers can protect themselves. Human nature hasn’t changed all that much, despite our technological advances. Please understand that I am not placing the blame solely on doctors. There’s plenty to go around in this tale of antagonism and mutual distrust, as Dr. Rizk implies. Still, the mantra of hope is very much in vogue these days, so let’s grasp at straws. I understand that the Irish ceasefire still holds. MC JOHN MARCILLE Managing Editor FRANK DIAMOND Associate Editor T 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 President and Group Publisher TIMOTHY P. SEARCH, RPH President and Group Publisher TIMOTHY J. STEZZI Eastern Sales Manager SCOTT MACDONALD Senior Account Manager KENNETH D. WATKINS, III Director of Production Services CONTACT E-MAIL ADDRESSES: Editors: Editors_mail@ManagedCareMag.com Circulation: Managedcare@icnfull.com Advertising: Advertising_info@ManagedCareMag.com Reprints: Reprints_request@ManagedCareMag.com WANETA PEART Circulation Manager 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 18, Issue 2. 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 2009 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. FEBRUARY 2009 / MANAGED CARE 1
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