Managed Care - August 2012 - (Page 2)

16 Timothy S. Jost, JD Vol. 21, No. 8 August 2012 C O V E R ST O R Y Private Exchanges: Practice Makes Perfect e A ordable Care Act is having a signi cant e ect on the sale and marketing of health insurance. Health plans are changing how they sell it. Employers are changing how they buy it. 16 26 Sharon Levine, MD Hospitals and Providers Ganging Up on Plans? Aetna, WellPoint, UnitedHealthcare, and Cigna respond to expanding provider power by forming their own alliances and creating their own accountable care organizations. It’s a new world. 23 Q&A: Kaiser Permanente’s Sharon Levine, MD For more than 30 years, KP has been, in e ect, an accountable care organization, says Levine, the associate executive director of the Permanente Medical Group of Northern California. 26 God Save the Health Care System! 32 Robert Royce, PhD We might think that under socialized medicine, providers would be protected from disaster, but in the U.K., that’s not the case. Will U.S. companies export their managerial expertise? 32 Future Points to Greater PBM/Plan Cooperation e growth of the specialty drug market along with demands for transparency will require PBMs to be more active on behalf of payers and patients. 37 DEPARTMENTS Editor’s Memo ..........................................1 Compensation Monitor.................... 14 Claim processing improves. 37 Warren K. Williams Find us on Facebook Search for “Managed Care” Follow us on Twitter @managedcaremag Electronic Edition www.managedcaremag.com/ nxtbook Getting a jump on exchanges. Legislation & Regulation ....................5 Will some plans miss Medicaid bonanza? Formulary Files .................................... 41 Formulary changes upset members. News & Commentary............................7 Docs forge informal “networks.” Plan Watch .............................................. 43 Nurses motivate by talking. Medication Management ............... 10 Improving postmarket safety. Tomorrow’s Medicine........................ 45 Belviq o ers some weight-loss help. Evidence Review.................................. 12 ECRI looks at MelaFind. Outlook .................................................... 47 Employers to expand wellness programs. Web: www.managedcaremag.com Search for “Managed Care” COVER PHOTOGRAPH: George H. H. Huey/Corbis http://www.managedcaremag.com/nxtbook http://www.managedcaremag.com http://www.managedcaremag.com/nxtbook

Table of Contents for the Digital Edition of Managed Care - August 2012

Managed Care - August 2012
Editor’s Memo
Contents
Legislation & Regulation
News & Commentary
Medication Management
Evidence Review
Compensation Monitor
Private Exchanges: Practice Makes Perfect
Hospitals and Providers Ganging Up on Plans?
Q&A: Kaiser Permanente’s Sharon Levine, MD
God Save the Health Care System!
Future Points to Greater PBM/Plan Cooperation
Formulary Files
Plan Watch
Tomorrow’s Medicine
Outlook

Managed Care - August 2012