Held in the balance.
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The competitive medical plan (CMP) is a newly created alternative delivery system. Qualified organizations that are found to be "eligible" CMPs can negotiate contracts with HCFA to serve Medicare recipients under a cost contract or risk contract.
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Legislation proposed in the 100th Congress and debated during the summer of 1987 would cover prescription drug spending by Medicare enrollees after the enrollee had met a deductible. However, at the time that the legislation was proposed, there were no comprehensive estimates of the extent of current expenditures for prescription drugs by that population, nor of the expected cost of the proposed coverage. In this article, the author estimates "current-law" drug spending by Medicare enrollees. A distribution around the average expenditure is developed, demonstrating the proportion of users that exceed any given annual expenditure and the proportion of total expenditures comprised by spending in excess of that "deductible."
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The purpose of this paper is to assess the level of marketing spending in the HMO industry and the enrollment growth HMOs have achieved in return for their marketing dollars. This study identifies industry norms that are designed to assist HMOs in the evaluation of their marketing performance. The study is based on data from 1985 to 1986 covering approximately half the HMOs in the country and comprising a substantial proportion of industry-wide enrollment (Table 1). The analyses are designed to allow operational HMOs to compare their marketing efforts, enrollment growth, and marketing costs per new member with industry norms within similar age, model type, enrollment level, and geographic categories. The marketing expenses provided by each HMO are an aggregate figure including sales staff salaries, benefits and commissions, advertising, costs for the production and printing of marketing materials, and all other expenses directly related to the marketing effort. Components of the aggregate marketing expenses, such as the amount spent on advertising versus sales staff compensation, were not available.
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Brompton's cocktail is an oral formulation used widely for intractable pain associated with cancer. In the United States, however, formulations are not standard, and questions concerning the efficacy and safety of some ingredients have been raised. Hospitals were surveyed to determine the formulation of Brompton's cocktail used, how the cocktail is compounded, and who is responsible for deciding on the pain cocktail formula. Controversy surrounding the use of cocaine as an ingredient is discussed, and problems with dating of formulations are described. P & T Committees are encouraged to review the literature concerning pain cocktail formulations and reevaluate the use of pain cocktails within their own institutions.
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OBJECTIVE: To find the differences between telephone and mail interview respect on answer rate, economic cost and characteristics of participants. To determine the knowledge of our diabetics about their disease. DESIGN: A descriptive transversal study. SETTING: Primary care Centro de San Gregorio, Telde, Las Palmas. PATIENTS: The diabetics type 1 and 2 (n = 566) of our centre, whose ages were 18-70 years. In order to apply the same health questionnaire through two different ways, we divided the sample into two random groups: mail group (n = 283) and telephone group (n = 283). RESULTS: The global answer rate was 51.6% (292 patients), 48% in the mail group (136 patients) and 55% in the telephone group (156 patients). The total cost of the mail survey was 41,000 pts. (104 pts. per mail), and the cost of telephone survey was 5.100 pts. (25.5 pts. per useful call). In the whole sample, we observed women more frequently in the answer group (56% of 292) than in the no answer group (44% of 274) (CI 95% 8.1-12.8). Also, in the answer group, the age was greater than in the no answer group (58.8 +/- 9.8 yr vs. 55.8 +/- 12.5 yr) (CI 95% 1.14-4.8). When we analyzed gender and age in each group, we observed the same differences in the telephone group but not in the mail group. More than the half questionnaire were correctly answer by 64% (167 patients). In the telephone group the "fit" rate was greater (70.6% of 153) than in the mail group (55.7% of 106) (CI 95% 3.2-26.6). CONCLUSIONS: A suitable answer rate was reached through both methods of interview, but telephone survey's was smaller. In the mail group, both genders and all ages groups answered in the same way. The knowledge of our diabetics about their disease was like as the found in another studies.
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