Taking Stock at 2 Years - Continuing the Journey

It has been 2 years since we accepted the positions of co-editors of The American Journal of Managed Care. One of the most common questions we are asked is whether anyone is interested in managed care these days. Our belief is that despite the backlash against "managed care," the challenges of managing the efficient delivery of care to the population remain as strong as ever. We take this broad view of managed care to encompass all of the efforts undertaken to improve care—at all levels of the healthcare system—and consider the Journal, and the issues it addresses, more relevant than ever.

Despite the generally perceived demise of managed care, the healthcare industry as a whole remains incredibly entrepreneurial with advances in information systems and managerial tools affecting all types of care delivery, ranging from inpatient services to prescribed medications. Barriers erected to contain costs continue to be developed at the same time initiatives are undertaken to improve access to care. In contrast to perceptions of the retreat of managed care, activities to improve quality and safety and manage costs continue. Those activities require rigorous evaluations, which is where this journal comes in.

We strive to provide the information necessary to help decision makers manage in today's environment.Our objective is to disseminate research that will facilitate the translation and integration of research into practice. Given our unique circulation to more than 50 000 decision makers and our reputation for providing credible, relevant research, we believe we are in an outstanding position to achieve this objective.

Central to this goal is high quality, peer-reviewed research. For example, our impact factor, which measures the number of times recent articles in the have been cited by other authors in the scientific literature has increased nearly 50% over 2 years. Several of the articles we've published have received awards. The paper by Emily Cox and colleagues in our December 2003 issue,¹ for example, was recognized by the International Society for Pharmacoeconomics and Outcomes Research with its 2004 "Excellence Award for Practical Application Excellence." An article by Ian Duncan and colleagues² was recognized by the Disease Management Association of America as the "Best Journal Article on Disease Management" for 2003. Moreover, we continue to receive high rankings in overall quality and readership among the journals in our category, as judged by the independent firm PERQ/HCI.

In addition to our 12 regular monthly issues, we have published several special issues and theme issues that have been well received. In the past 2 years we have published extra issues on Evaluating Health Plan Quality,^2-8 Cost Drivers in Healthcare,^9-13 Diabetes Mellitus,^14-22 and Cardiovascular Health.^23-29 Future themes will include coverage on the VA system, reducing racial disparities, Medicare and Medicaid, and diabetes. Full text of these issues, as well as online issues of the Journal, can be accessed on our re-designed website at www.ajmc.com.

Working on these special issues has allowed us the opportunity to collaborate with research institutions and organizations to expand our reach. When we accepted the Editor positions, one of our goals was to tap into researchers based in healthcare systems. We recognize that much of the important research in our areas of interest is being conducted within healthcare systems, many of which have built outstanding and influential research groups that compete successfully for federal funding and publish in top journals (including AJMC).

In this spirit, we have reached out to the HMO Research Network (HMORN), an alliance of researchers based in health systems. We are proud that 3 of the members of the HMO Research Network executive board serve on our editorial board (Jennifer Elston-Lafata, Andrew Nelson, and Deborah Shatin). This issue features a contribution by Tom Vogt and other members of the HMORN, who discuss, in general, the importance of health systems–based research and, in particular, the function of the HMORN.³⁰ Additionally, we are highlighting selected abstracts from the 2004HMO Research Network Annual Meeting in this issue in an effort to present cutting edge research to a new, and hopefully appreciative, audience. The remainder of the abstracts from their annual meeting can be accessed from our web site (www.ajmc.com), where you can also find a link to the HMO Research Network web site. Finally, we have expanded the Journal's circulation to members of the HMO Research Network and hope to continue to work with this organization, and other health systems–based researchers, to disseminate the research needed to achieve our collective goal of improving the effectiveness and efficiency of our healthcare system.

References

1. Cox E, Motheral B, Mager D. Verification of a decision analytic model assumption using real-world practice data: implications for the cost effectiveness of cyclo-oxygenase 2 inhibitors (COX-2s). Am J Manag Care. 2003;9:785-794.

2. Dove HG, Duncan I, Robb A. A prediction model for targeting low-cost, high-risk members of managed care organizations. Am J Manag Care. 2003;9:381-389.

3. Gabel J, Fitzner K. New evidence to explain rising healthcare costs. Am J Manag Care. 2003;9:SP1-SP2.

4. Goetghebeur MM, Forrest S, Hay JW. Understanding the underlying drivers of inpatient cost growth: a literature review. Am J Manag Care. 2003;9:SP3-SP12.

5. Hay JW. Hospital cost drivers: an evaluation of 1998-2001 state-level data. Am J Manag Care. 2003;9:SP13-SP24.

6. Hearle K, Koenig L, Rudowitz R, Siegel JM, Dobson A, Ho S. Drivers of expenditure growth in outpatient care services. Am J Manag Care. 2003;9:SP25-SP33.

7. Koenig L, Siegel JM, Dobson A, Hearle K, Ho S, Rudowitz R. Drivers of healthcare expenditures associated with physician services. . 2003;9:SP34-SP42.

8. Siegrist RB Jr, Kane NM. Exploring the relationship between inpatient hospital costs and quality of care. Am J Manag Care. 2003;9:SP43-SP49.

9. Wholey DR, Christianson JB, Finch M, Knutson D, Rockwood T, Warrick L. Evaluating Health Plan Quality 1: a conceptual model. Am J Manag Care. 2003;9:SP53-SP64.

10. Wholey DR, Christianson JB, Finch M, Knutson D, Rockwood T, Warrick L. Evaluating Health Plan Quality 2: survey design principles for measuring health plan quality. Am J Manag Care. 2003;9:SP65-SP75.

11. Wholey DR, Finch M, Christianson JB, Knutson D, Rockwood T, Warrick L. Evaluating Health Plan Quality 3: survey measurement properties. Am J Manag Care. 2003;9:SP76-SP-87.

12. Wholey DR, Christianson JB, Fossum Jones K, Finch M. What do physician recommendations of health plans mean? Am J Manag Care. 2003;9:SP88-SP99.

13. Bindman AB, Wholey DR, Christianson JB. Physicians' reports of their experience with health plan care management practices. Am J Manag Care. 2003;9:SP100-SP110.

14. Heisler M, Wagner EH. Improving diabetes treatment quality in managed care organizations: some progress, many challenges. Am J Manag Care. 2004;10(part 2):115-117.

15. Nau DP, Garber MC, Herman WH. The intensification of drug therapy for diabetes and its complications: evidence from 2 HMOs. Am J Manag Care. 2004;10(part 2):118-123.

16. Timpe EM, Amarshi N, Reed PJ. Evaluation of angiotensin-converting enzyme inhibitor use in patients with type 2 diabetes in a state managed care plan. Am J Manag Care. 2004;10(part 2):124-129.

17. Fuke D, Hunt J, Siemienczuk J, et al. Cholesterol management of patients with diabetes in a primary care practice-based research network. Am J Manag Care. 2004;10(part 2):130-136.

18. Kim C, Williamson DF, Herman WF, et al. Referral Management and the care of patients with diabetes: the Translating Research Into Action for Diabetes(TRIAD) study. Am J Manag Care. 2004;10(part 2):137-143.

19. Hepke KL, Martus MT, Share DA. Costs and utilization associated with pharmaceutical adherence in a diabetic population. Am J Manag Care. 2004;10(part2):144-151.

20. Piette JD, Richardson C, Valenstein M. Addressing the needs of patients with multiple chronic illnesses: the case of diabetes and depression. Am J Manag Care. 2004;10(part 2):152-162.

21. Selby JV, Peng T, Karter AJ, et al. High rates of co-occurrence of hypertension, elevated low-density lipoprotein cholesterol, and diabetes mellitus in a large managed care population. Am J Manag Care. 2004;10(part 2):163-170.

22. Pogach L, Charns MP, Wrobel JS. Impact of policies and performance measurement on development of organizational coordinating strategies for chronic care delivery. Am J Manag Care. 2004;10(part 2):171-180.

23. Mukherjee D, Eagle KA. Improving quality of cardiovascular care in the real world: how can we remove the barriers? Am J Manag Care. 2004;10:471-472.

24. Borzecki AM, Wong AT, Hickey EC, Ash AS, Berlowitz DR. Can we use automated data to assess quality of hypertension care? Am J Manag Care. 2004;10:473-479.

25. Andrade SE, Gurwitz JH, Field TS, et al. Hypertension management: the care gap between clinical guidelines and clinical practice. Am J Manag Care. 2004;10:481-486.

26. Franciosa JA. The potential role of community-based registries to complement the limited applicability of clinical trial results to the community setting: heart failure as an example. Am J Manag Care. 2004;10:487-492.

27. Zukerman IH, Weiss SR, McNally D, Layne B, Mullins CD, Wang J. Impact of an educational intervention for secondary prevention of myocardial infarction on Medicaid drug use and cost. Am J Manag Care. 2004;10:493-500.

28. Berthiaume JT, Tyler PA, Ng-Osorio J, LaBresh KA. Aligning financial incentives with "Get With The Guidelines" to improve cardiovascular care. Am J Manag Care. 2004;10:501-504.

29. Volpp KG, Buckley E. The effect of increases in HMO penetration and changes in payer mix on in-hospital mortality and treatment patterns for acute myocardial infarction. Am J Manag Care. 2004;10:505-512.

30. Vogt TM, Elston-LaFata J, Tolsma D, Greene SM. The role of research in integrated healthcare systems: the HMO Research Network. Am J Manag Care. 2004;10:643-648.

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