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.
Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury
February 21st 2025Among hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.
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Managed Care Reflections: Insights From Richard J. Gilfillan, MD; and Donald M. Berwick, MD, MPP
February 20th 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes reflections from a thought leader on what has changed over the past 3 decades and what’s next for managed care. The February issue features a retrospective by Richard J. Gilfillan, MD, former director of the Center for Medicare and Medicaid Innovation; and Donald M. Berwick, MD, MPP, former administrator of CMS.
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Medical Policy Determinations for Pharmacogenetic Tests Among US Health Plans
February 10th 2025This analysis demonstrated significant variability in medical policy determinations and evidence cited for clinically relevant pharmacogenetic tests among major US health insurers and laboratory benefit managers.
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