Opioids offer effective pain relief, but dosages vary widely
September 1st 2004MORPHINE, the first and best-known of the opioid analgesics, is a natural substance produced from the opium poppy, papaver somniferum. It's been used to relieve pain since ancient times; Hippocrates prescribed poppy juice as a narcotic. Today many different semisynthetic opioid analgesics are used to relieve moderate to severe pain, but morphine remains the standard of comparison used to describe their effectiveness.
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AS AN ANONYMOUS but perceptive comedian once said, "Money talks, but all mine ever says is goodbye." The healthcare industry has been saying the same thing since long before managed care arrived on the scene, so it's no surprise that its less-than-sparkling financial history has led some experts to look for solutions that have nothing to do with economics.
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Your roadmap for HIPAA safeguards
September 1st 2004The Administrative Simplification section of HIPAA consists of a trioof regulations that address privacy, transactions and security. Implementationof the final Security Rule and its mandated security practices must be ineffect as of April 20, 2005, for most covered entities. Although the PrivacyRule requires the presence of "adequate safeguards" for ProtectedHealth Information (PHI), the Security Rule details more than 40 separateaudit points within the categories of technical, administrative and physicalsafeguards. While the Security regulation addresses what must be done, itdoes not provide a road map for how to do it.
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Responding to growth through HR and payroll outsourcing
September 1st 2004The decision to seek HR and payroll outsourcing services for SomerfordCorp.'s 13 assisted living facilities was directly related to growth. Theacquisition of a California-based healthcare provider in October, 2001,doubled Somerford's employee population and added six facilities to thecompany, and also increased the complexity of HR management.
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Sept. DTR Anaylsis: Population differences key in to the HMO trends
September 1st 2004In the highest-enrollment states, not only are there higher populations generally, but the population also is more concentrated, and HMOs operated there successfully for longer periods before the anti-managed care movement began to really get legs, according to one expert.
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Consumer-Directed Healthcare and Meeting the IT Challenge
August 1st 2004The demand for consumer-directed healthcare (CDH) is growing. Once justan idea tossed around in health plan boardrooms and industry think tanks,CDH is now taking root, with an increasing number of national and regionalhealth plans offering a variety of consumer-directed products and services.
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Special Report Web Exclusive: Diversity, To Ask or Not to Ask
August 1st 2004Is it legal to ask health plan members their race and ethnicity? Accordingto the Civil Rights Act of 1964, it is; however, California, New Jersey,New Hampshire and Maryland restrict the use and collection of racial data.With the go-ahead from the federal government, health insurers are usingthe data to design strategies to improve care for specific populations.
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Combined therapy provides better control of HIV
August 1st 2004The human immunodeficiency virus (HIV) attacks the immune system, particularly white blood cells known as CD4 T-cells. As a result, the immune system becomes less able to fight off infection and disease. The final stage of HIV infection is acquired immunodeficiency syndrome (AIDS), but some people live with HIV for years or even decades before the disease progresses to AIDS.
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Health insurers learned long ago that one size doesn't fit all. As a result, they tailor care delivery to members based on specific disease states, gender, age and risk status. But today, that simply is not sufficient-not with the U.S. Bureau of Census' prediction that by 2035, Americans of color will comprise more than 40% of the population.
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Industry protected under ERISA as Texas state law is pre-empted
August 1st 2004On June 21, a unanimous U.S. Supreme Court held that state law is completely pre-empted by the Employee Retirement Income Security Act (ERISA)of 1974 with respect to disputes over denial of benefits under ERISA-regulated health benefit plans. The Court's ruling appears to insulate managed care organizations from punitive and extra-contractual damages related to denial of benefits. In its decision, the Court overruled two lower court rulings.
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The pain associated with a degenerative hip condition had 37-year-old Gerald Amaral taking several prescription pain tablets on a daily basis to manage his discomfort. It's hard to believe that doctors say this former competitive mountain bike racer has the hip of a 70-year-old man.
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Recent acquisition fixation requires regulatory guidance
July 1st 2004In the first half of this year, there have been several significant business transactions in the managed care industry that have either been completed or announced. Just to name a few, Anthem and WellPoint Health Networks are merging; UnitedHealthcare acquired Mid-Atlantic Medical Services; Humana acquired Ochsner Health Plan; UnitedHealthcare announced the acquisition of Oxford Health Plans; and Molina Healthcare announced its acquisition of Cimarron Health Plan. In this highly regulated industry, these types of transactions require various regulatory approvals. With so much activity this year, it is important to highlight some of the necessary procedures for potential acquirers and targets.
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The more hands to work on healthcare's knots, the better
July 1st 2004According to Greek legend, a poor peasant named Gordius became the king of the Asian country of Phrygia because of a rather vague prophecy. An oracle had prophesied that the nation’s future ruler would come riding into town on a wagon, so when Gordius and his wife arrived in the public square driving an ox cart, the populace named him king.
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