Managing anticoagulation therapy has been difficult and costly for providers and for payers, as complications are common. For example, the cost of mitigating a single anticoagulation related hemorrhagic complication can exceed $10,000 per claim. In 2002, CMS initiated a new model of anticoagulation patient management that combines technology with remote monitoring to improve traditional care. Managed care organizations are now adopting this model, and improved outcomes at lower cost should result.
{"title":"MCOs following innovative CMS remote monitoring initiative: self-testing service is designed to lower costs and improve outcomes for anticoagulation therapy.","authors":"Richard Albrecht","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Managing anticoagulation therapy has been difficult and costly for providers and for payers, as complications are common. For example, the cost of mitigating a single anticoagulation related hemorrhagic complication can exceed $10,000 per claim. In 2002, CMS initiated a new model of anticoagulation patient management that combines technology with remote monitoring to improve traditional care. Managed care organizations are now adopting this model, and improved outcomes at lower cost should result.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"14 1","pages":"13-6"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26796099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cost-shifting, insurer profits, and health promotion programs are slowing rate increases.","authors":"Allan Fine","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"14 1","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26796107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the past several years, discount medical programs have flourished as a result of double digit increases in health insurance premiums. Given the rapid growth and sometimes questionable practices of such programs, several states have taken notice and have begun to regulate discount medical programs. This article summarizes the laws of several states that have chosen to oversee these programs.
{"title":"State regulation of medical discount programs: a new frontier.","authors":"J Peter Rich","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Over the past several years, discount medical programs have flourished as a result of double digit increases in health insurance premiums. Given the rapid growth and sometimes questionable practices of such programs, several states have taken notice and have begun to regulate discount medical programs. This article summarizes the laws of several states that have chosen to oversee these programs.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"14 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26796097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
"Loyalty rewards" in sponsored DM and HRM programs can apply to both providers and consumers. Physicians and hospitals can be paid to "loyally" adhere to payers' guidelines for managing diseases and risks. Many payer and their outsourced vendor programs include significant efforts to create collaborations between payer and provider, rather than relying on unilateral efforts. And growing numbers are rewarding providers for their efforts and results achieved.
{"title":"A new \"loyalty rewards\" program in health care customer relationships.","authors":"Scott Macstravic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>\"Loyalty rewards\" in sponsored DM and HRM programs can apply to both providers and consumers. Physicians and hospitals can be paid to \"loyally\" adhere to payers' guidelines for managing diseases and risks. Many payer and their outsourced vendor programs include significant efforts to create collaborations between payer and provider, rather than relying on unilateral efforts. And growing numbers are rewarding providers for their efforts and results achieved.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"14 1","pages":"10-2"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26796098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oath-based behavior change in \"out-of-control\" type 2 diabetics?","authors":"Mark Hochhauser","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"14 1","pages":"17-9"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26796100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Federal initiatives to improve patient care are questioned.","authors":"Allan Fine","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"14 1","pages":"27-8"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26796105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}