HMOs have options in asset sales, but transactions are tightly governed
September 1st 2004An asset sale by an insurance company or a health maintenance organization typically involves the transfer of a block of business and generally is accomplished by an "assumption" or "portfolio" reinsurance transaction (when risk is transferred from one insurer to another) covering part or all of the seller's existing business.
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Musculoskeletal pain is more than just a pain in the neck
September 1st 2004The Centers for Disease Control and Prevention cites pain as the number one cause of disability in America. It's a widespread, complex affliction that significantly increases healthcare costs and decreases work force productivity. With more than 50 million Americans either partially or completely disabled by pain and nearly two-thirds of full-time workers with painful conditions, health plans and employers now shoulder a greater burden of the pain.
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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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Glycemic control and pulmonary function sustained throughout long-term use of inhalable insulin
August 1st 2004Two studies evaluating the efficacy and long-term safety of the inhalable, rapid-acting dry powder insulin formulation (Exubera, Pfizer/Aventis) demonstrate that the drug was able to sustain glycemic control and pulmonary function in patients with type 2 diabetes
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Etanercept/anakinra RA combination therapy has increased risk compared to etanercept monotherapy
August 1st 2004Etanercept/anakinra combination therapy for the treatment of rheumatoid arthritis (RA) provides no added benefit and has an increased risk compared to etanercept alone, according to a study published in Arthritis & Rheumatism, the journal of the American College of Rheumatology (ACR).
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Initial days of antidepressant therapy associated with greatest risk of suicidal behavior
August 1st 2004Four commonly prescribed antidepressants carry an equal risk of quadrupling the chance of suicidal behavior during the first 9 days of treatment, according to a study from the United Kingdom published in the Journal of the American Medical Association. The authors cautioned, however, that the risk is likely only temporary and may be attributed to the time period in which the drugs have not yet taken effect in those patients already considering suicide.
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Imiquimod for superficial basal cell carcinoma
August 1st 2004Although the mechanism of action of imiquimod is unknown, an open-label study suggests that the drug may act by increasing the filtration of lymphocytes, dendritic cells, and macrophages into the tumor lesion. Imiquimod was approved on July 14, 2004, for an expanded indication to include the treatment of biopsy-confirmed, primary superficial basal cell carcinoma (sBCC) in immunocompetent adults.
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New NCEP cholesterol management guidelines recommend lower LDL treatment goals
August 1st 2004A newly released update to the National Cholesterol Education Program's (NCEP) guidelines on cholesterol management recommend that clinicians consider more intensive treatment options for patients at high and moderately high risk for heart attack. These evidence-based recommendations include setting lower treatment goals for low-density lipoprotein cholesterol (LDL-C) and initiating cholesterol-lowering drug therapy at lower LDL thresholds.
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Focus on ximelagatran: A new oral anticoagulant
August 1st 2004Although warfarin is an effective drug in the treatment and prevention of thromboembolism, dosing complexities and drug interactions have led to its underutilization and a desire for an alternative agent. Ximelagatran (Exanta, AstraZeneca) is a novel oral anticoagulant that can be taken in standardized doses without the use of periodic blood monitoring to determine the level of anticoagulation. Large prospective clinical trials have shown ximelagatran to be similar in efficacy compared to the standard of therapy in the prevention and treatment of thromboembolism with similar or lower rates of bleed. Of concern, however, is the fact that that ximelagatran may elevate hepatic enzymes. An NDA was filed for ximelagatran on December 23, 2003, and FDA’s Cardiovascular and Renal Drugs Advisory Committee is scheduled to review the drug for the prevention of stroke and thromboembolism at a meeting on September 10, 2004. This article reviews ximelagatran’s chemistry and pharmacology, pharmacokinetics, clinical trials, adverse effects, drug interactions, and dosage and administration.
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Perspectives on empiric and chronic proton pump inhibitor therapy
August 1st 2004The number of patients presenting with typical gastroesophageal reflux disease (GERD) symptoms and the prevalence of GERD symptoms in the general population make the prescription of proton-pump inhibitors (PPIs) by primary-care physicians commonplace. An active medication use evaluation (MUE) program that places symptom control as a primary concern can help rationalize PPI drug therapy and improve patient care. A treatment guideline that follows the current practice of empiric therapy, recommends periodic monitoring, and encourages further gastroesophageal evaluation (ie, endoscopy and pH monitoring) for assessing adequacy of treatment and treatment failures is a key component of a successful program.
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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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