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December 2010 - FRMC

News Connection
01/13/2011
Kerri Fitzgerald
A Kaiser Family Foundation survey found that premiums for employer-based healthcare continue to increase due to the economy.
A Kaiser Family Foundation survey found that premiums for employer-based healthcare continue to increase due to the economy.
A Kaiser Family Foundation...
01/13/2011
First Report Managed Care
Feature
01/04/2011
Kevin L. Carter
Myelofibrosis, a Philadelphia chromosomenegative myeloproliferative neoplasm, is characterized by progressive anemia, bone marrow fibrosis and splenomegaly, and produces debilitating symptoms. About 50% of patients with myelofibrosis carry a...
Myelofibrosis, a Philadelphia chromosomenegative myeloproliferative neoplasm, is characterized by progressive anemia, bone marrow fibrosis and splenomegaly, and produces debilitating symptoms. About 50% of patients with myelofibrosis carry a...
Myelofibrosis, a Philadelphia...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Kevin L. Carter
Women who have inherited mutations in the BRCA1 or BRCA2 genes have substantially elevated risks of breast cancer and ovarian cancer, with a lifetime risk of breast cancer of 56% to 84%. 
Women who have inherited mutations in the BRCA1 or BRCA2 genes have substantially elevated risks of breast cancer and ovarian cancer, with a lifetime risk of breast cancer of 56% to 84%. 
Women who have inherited...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Tori Socha
Delivering evidence-based therapies to patients with heart failure has proven a challenge to healthcare practitioners. The rates of nonadherence to drug therapies prescribed to treat heart failure range from 30% to 60%, and the rates of...
Delivering evidence-based therapies to patients with heart failure has proven a challenge to healthcare practitioners. The rates of nonadherence to drug therapies prescribed to treat heart failure range from 30% to 60%, and the rates of...
Delivering evidence-based...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Tori Socha
Patient satisfaction with treatment and their use of preventive services can be increased with utilization of telephone interventions designed to promote self-management skills and to improve communication between patients and physicians. To...
Patient satisfaction with treatment and their use of preventive services can be increased with utilization of telephone interventions designed to promote self-management skills and to improve communication between patients and physicians. To...
Patient satisfaction with...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Tori Socha
Studies on mistakes in medical care have largely focused on inpatient care, but there is evidence that patients perceive mistakes in their ambulatory care as well. The majority of the research on mistakes and errors in ambulatory care...
Studies on mistakes in medical care have largely focused on inpatient care, but there is evidence that patients perceive mistakes in their ambulatory care as well. The majority of the research on mistakes and errors in ambulatory care...
Studies on mistakes in medical...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Jill Sederstorm
Medicare Part D drug plans vary widely in terms of coverage, tier placement, and cost-sharing for top brand-name and specialty drugs, according to the findings of an analysis by the Henry J. Kaiser Family Foundation. 
Medicare Part D drug plans vary widely in terms of coverage, tier placement, and cost-sharing for top brand-name and specialty drugs, according to the findings of an analysis by the Henry J. Kaiser Family Foundation. 
Medicare Part D drug plans vary...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Jill Sederstorm
A report analyzing key changes in the Medicare Part D program since it began in 2006 found that there have been significant increases to premiums, cost-sharing amounts, and the use of utilization management (UM) restrictions over time. 
A report analyzing key changes in the Medicare Part D program since it began in 2006 found that there have been significant increases to premiums, cost-sharing amounts, and the use of utilization management (UM) restrictions over time. 
A report analyzing key changes...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Jill Sederstorm
A new report examining the first 5 years of the Medicare Part D Low-Income Subsidy (LIS) program found that since its inception, the program has helped connect low-income patients with affordable prescription drugs; however, the program’s...
A new report examining the first 5 years of the Medicare Part D Low-Income Subsidy (LIS) program found that since its inception, the program has helped connect low-income patients with affordable prescription drugs; however, the program’s...
A new report examining the first...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Mary Beth Nierengarten
Results of an observational study [N Engl J Med. 2010;363(12):1128-1138] suggest that patients with chronic obstructive pulmonary disease (COPD) who have more frequent exacerbations appear to have a distinct susceptibility phenotype that is...
Results of an observational study [N Engl J Med. 2010;363(12):1128-1138] suggest that patients with chronic obstructive pulmonary disease (COPD) who have more frequent exacerbations appear to have a distinct susceptibility phenotype that is...
Results of an observational...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Asher Block
Patients with atrial fibrillation (AF) usually require long-term oral anticoagulation and platelet inhibition, which is indicated by coexisting vascular disease, such as ischemic heart disease. 
Patients with atrial fibrillation (AF) usually require long-term oral anticoagulation and platelet inhibition, which is indicated by coexisting vascular disease, such as ischemic heart disease. 
Patients with atrial...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Tori Socha
Communication between patients and physicians is central to establishing good clinical relationships. It also improves adherence to medication therapies and patient satisfaction with the care he or she receives. Care that focuses on the...
Communication between patients and physicians is central to establishing good clinical relationships. It also improves adherence to medication therapies and patient satisfaction with the care he or she receives. Care that focuses on the...
Communication between patients...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Tori Socha
Although clopidogrel and aspirin are commonly used agents for patients with cardiovascular disease, uncertainty about the optimal dose for each agent has resulted in wide geographic variations in practice patterns for patients with acute...
Although clopidogrel and aspirin are commonly used agents for patients with cardiovascular disease, uncertainty about the optimal dose for each agent has resulted in wide geographic variations in practice patterns for patients with acute...
Although clopidogrel and aspirin...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Tori Socha
Many healthcare systems use primary care physician (PCP) clinical performance assessment when making decisions about recredentialing; pay-for-performance and public reporting programs are common methods for influencing physician performance. 
Many healthcare systems use primary care physician (PCP) clinical performance assessment when making decisions about recredentialing; pay-for-performance and public reporting programs are common methods for influencing physician performance. 
Many healthcare systems use...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Tim Casey
A recent analysis of a large international registry found that clinicians can utilize clinical descriptors to predict future ischemic events in outpatients with atherothrombosis. During a 4-year follow-up period, subgroups of atherothrombotic...
A recent analysis of a large international registry found that clinicians can utilize clinical descriptors to predict future ischemic events in outpatients with atherothrombosis. During a 4-year follow-up period, subgroups of atherothrombotic...
A recent analysis of a large...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Jill Sederstorm
A new randomized trial comparing doses of clopidogrel and aspirin in patients with acute coronary syndromes who had been referred for an invasive strategy found that there was no significant difference between a double-dose clopidogrel...
A new randomized trial comparing doses of clopidogrel and aspirin in patients with acute coronary syndromes who had been referred for an invasive strategy found that there was no significant difference between a double-dose clopidogrel...
A new randomized trial comparing...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Eileen Koutnik-Fotopoulos
A recent study found that routine mammography screening reduced the mortality rate from breast cancer. However, this benefit accounted for only about one-third of the total reduction in breast cancer death rates.
A recent study found that routine mammography screening reduced the mortality rate from breast cancer. However, this benefit accounted for only about one-third of the total reduction in breast cancer death rates.
A recent study found that...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Tim Casey
Approximately 20% of cancer patients suffer from venous thromboembolism, which is 4 to 7 times more likely in cancer patients than in the general population and can lead to long-term complications.
Approximately 20% of cancer patients suffer from venous thromboembolism, which is 4 to 7 times more likely in cancer patients than in the general population and can lead to long-term complications.
Approximately 20% of cancer...
01/04/2011
First Report Managed Care
Conference Insider
01/04/2011
Tim Casey
Although 2.5 million people have multiple sclerosis (MS), diagnosing MS remains difficult and treatment for the disease varies based on numerous factors. 
Although 2.5 million people have multiple sclerosis (MS), diagnosing MS remains difficult and treatment for the disease varies based on numerous factors. 
Although 2.5 million people have...
01/04/2011
First Report Managed Care
Conference Insider
01/04/2011
Tim Casey
According to Mary Emma Karam, senior counsel at Jackson Waller LLP, only 1 of 300 lawyers at her firm completely understands the Employee Retirement Income Security Act (ERISA), a complicated law that she said befuddles most lawyers. 
According to Mary Emma Karam, senior counsel at Jackson Waller LLP, only 1 of 300 lawyers at her firm completely understands the Employee Retirement Income Security Act (ERISA), a complicated law that she said befuddles most lawyers. 
According to Mary Emma Karam,...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Tim Casey
Las Vegas—With numerous forms of breast cancer found in patients, physicians must use available information and tools to offer personalized treatment options, according to remarks presented during a session at the Fall Managed Care Forum...
Las Vegas—With numerous forms of breast cancer found in patients, physicians must use available information and tools to offer personalized treatment options, according to remarks presented during a session at the Fall Managed Care Forum...
Las Vegas—With numerous forms of...
01/04/2011
First Report Managed Care
Conference Insider
01/04/2011
Tim Casey
With an evolving federal and state regulatory environment, pricing and payment models in the healthcare industry are changing, making it crucial that providers and payers collaborate and explore various business models, according to speakers...
With an evolving federal and state regulatory environment, pricing and payment models in the healthcare industry are changing, making it crucial that providers and payers collaborate and explore various business models, according to speakers...
With an evolving federal and...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Tim Casey
Advances in medical technology can contribute to better outcomes, improve diagnostic acumen, and lead to more standardization in care.
Advances in medical technology can contribute to better outcomes, improve diagnostic acumen, and lead to more standardization in care.
Advances in medical technology...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Tim Casey
As the population in the United States ages, there has been an increase in the prevalence of Parkinson’s disease (PD), which has led to physicians focusing on treatment therapies to manage the disease and reduce costs. 
As the population in the United States ages, there has been an increase in the prevalence of Parkinson’s disease (PD), which has led to physicians focusing on treatment therapies to manage the disease and reduce costs. 
As the population in the United...
01/04/2011
First Report Managed Care
Conference Insider
01/04/2011
Tim Casey
With the passing of the Patient Protection and Affordable Care Act (HR 3590) in March and the introduction of accountable care organizations (ACOs) coming in the next few years, value-based benefit designs (VBDs) are becoming more important...
With the passing of the Patient Protection and Affordable Care Act (HR 3590) in March and the introduction of accountable care organizations (ACOs) coming in the next few years, value-based benefit designs (VBDs) are becoming more important...
With the passing of the Patient...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Tim Casey
When evaluating models to manage oncology programs, payers and providers must work together and consider areas such as transparency, collaboration, involvement of physicians, negotiations, and strategic direction.
When evaluating models to manage oncology programs, payers and providers must work together and consider areas such as transparency, collaboration, involvement of physicians, negotiations, and strategic direction.
When evaluating models to manage...
01/04/2011
First Report Managed Care
News Connection
01/04/2011
Tori Socha
Some health plans encourage their members to choose physicians who provide high-quality care, but most patients do not have access to physician quality measures. 
Some health plans encourage their members to choose physicians who provide high-quality care, but most patients do not have access to physician quality measures. 
Some health plans encourage...
01/04/2011
First Report Managed Care
Conference Insider
01/04/2011
Tim Casey
If providers are reimbursed through bundled payments there could be an estimated $17.8 billion in Medicare savings through 2019, mainly from a reduction in readmissions to hospitals, according to Jonathan W. Pearce, MBA, director at DGA...
If providers are reimbursed through bundled payments there could be an estimated $17.8 billion in Medicare savings through 2019, mainly from a reduction in readmissions to hospitals, according to Jonathan W. Pearce, MBA, director at DGA...
If providers are reimbursed...
01/04/2011
First Report Managed Care
Feature
01/04/2011
Tim Casey
Accountable care organizations (ACOs) will play a role in holding providers more accountable for controlling costs and improving clinical outcomes.
Accountable care organizations (ACOs) will play a role in holding providers more accountable for controlling costs and improving clinical outcomes.
Accountable care organizations...
01/04/2011
First Report Managed Care