What Comes After Managed Care?

Companies--and employees--have had it with HMOs. Here's how they're coping

General Motors Corp. (GM) has 217,000 employees in the U.S., including 180,000 auto workers, 16,000 engineers, and 2,000 managers. And one pharmacist. Why a pharmacist? It's a new strategy GM is using to rein in employee medical costs that, after years of being tame, are expected to jump by 11% this year, to nearly $4 billion. And the prescription-drug portion is expected to shoot up 31%, to $1 billion. "We needed to understand the situation better, and who better to help us understand pharmacy?" says James Cubbin, GM's head of health-care initiatives. The pharmacist, Cynthia Kirman, who started in 1999, tracks the drugs workers use most and uses the information to negotiate discounts with drugmakers.

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