Dear Reader,
The American Journal of Managed Care
In 2004, published more theme and special issues than ever before. That trend will likely continue in 2005, and you're holding the first evidence of this development.
The formulation and adoption of preferred drug lists (PDLs) by state and federal agencies is a fairly recent development. These PDLs have arisen both as a means to control costs and as response to changes in the Medicare drug law. Given the continuing evolution of these programs, and the further changes to the Medicare drug program set to take effect in 2006, it is important to examine these programs and their consequences in detail. That task is made difficult, however, due to the paucity of research available in this area. This collection of papers may begin to remedy that problem.
These 5 papers and the introduction to them should help sketch the landscape of drug access restrictions at the beginning of 2005, and will also hopefully lay out the areas where additional research is needed. As ever, we welcome your feedback on this special issue, and look forward to publishing additional theme and special issues as the year continues.
The Editors
Funding for this Special Issue was provided by Pfizer Inc, New York, NY.
Impact of Hospital-Physician Integration on Medicare Patient Mix
April 11th 2025This study found no evidence that hospital employment of physicians resulted in physicians treating sicker patients, undercutting claims that hospital-employed physicians serve a higher-acuity patient mix.
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Organizational Factors Associated With Variation in Primary Care Providers in ACOs
April 8th 2025A higher percentage of accountable care organization (ACO) primary care providers was associated with physician leadership, upside financial risk, and financial compensation of physicians tied to performance measures.
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A coverage with evidence development (CED) study demonstrated significant and clinically meaningful benefits in patients with migraine treated with remote electrical neuromodulation (REN). Health plans should support clinicians’ REN prescriptions by ensuring adequate coverage.
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