AJMC Celebrates 30th Anniversary

Michael Hennessy Jr

President and CEO

MJH Life Sciences^®

Letter from the president

Letter from the editors in chief

This milestone anniversary at The American Journal of Managed Care^® is our opportunity to celebrate a mission of 30 years: Delivering trusted insights that have shaped health care delivery and payment. Every day, we provide health care professionals, researchers, and policymakers with the knowledge and evidence they need to improve patient outcomes and redefine the future of medicine in the constantly shifting managed care landscape. We look to the future with an inspiring commitment to advance research and drive innovation to ensure a healthier, more connected world. Thank you for being an essential part of our journey! Here's to celebrating our collaborative work—and taking the next step together.

Our Impact by the Numbers
36,500+ Website Articles	8300+ Videos
7700+ Publication Articles	4800+ PubMed-Indexed Articles
970+ Issues*	550+ Podcasts
Metrics account for published content between 1995-2024. Issues include The American Journal of Managed Care®, The American Journal of Accountable Care®, Population Health Equity & Outcomes, and Evidence-Based Oncology®*.

The Managed Care Timeline

1996

HIPAA for Data Security: The Health Insurance Portability and Accountability Act is signed by President Clinton to protect personal health information and delineate national standards for health information transactions. This encouraged the use of e-prescribing and electronic medical records.

1999

To Err Is Human Reveals Massive Health Care Safety Issues: The Institute of Medicine publishes To Err Is Human: Building a Safer Health Care System, which found surprising numbers of preventable deaths related to hospital care and medication errors. This, and the subsequent Crossing the Quality Chasm, set off several public-private initiatives to improve care quality (eg, Bridges to Excellence, The LeapFrog Group).

2000

HMO Enrollment Peaks: Enrollment in health maintenance organizations (HMOs) reaches 81 million, but ends a winning streak of annual growth that extended back to the passage of the HMO Act. Consumer disenchantment with gatekeeping requirements and lack of provider choice, and the dominance of preferred provider organizations and point-of-service plans, slowed the growth of HMOs.

2001

Value-Based Insurance Design: Before they were coeditors in chief of AJMC^®, A. Mark Fendrick, MD, and Michael E. Chernew, PhD, publish the first paper on value-based insurance design in AJMC. Under their proposed benefit-based copay idea for prescription drugs, cost-sharing contributions would be based on the total clinical benefits of that drug for that patient, not the drug's acquisition cost.

2003

Medicare Modernization Act Passed: The Medicare Prescription Drug, Improvement, and Modernization Act ushers in a new pharmacy benefit covered by Medicare for millions of older Americans, in addition to health savings accounts. A boon to health plans and insurers, this signaled the start of Medicare Part D prescription drug benefits, and established regulations for Medicare Advantage plans—also known as Part C—which allow beneficiaries to receive Medicare benefits through private insurers.

2003

Pay-for-Performance Programs Appear: Bridges to Excellence (now Health Care Incentives Improvement Institute) is created as a collaboration of employers to financially reward physicians, nurse practitioners, and physician assistants who meet certain quality performance measures in specific disease areas. These pay-for-performance measures are approved by the American Medical Association's Physician Consortium on Performance Improvement and are included in the CMS Physician Quality Reporting Program.

2004

ERISA Is Upheld: A decision by the Supreme Court of the United States (Aetna Health Inc v Davila) denies the plaintiff’s suit to strike down the Employee Retirement Income Security Act of 1974 (ERISA), and instead eliminates statutes in 11 states that permitted patients covered under self-insured plans to sue HMOs for compensatory and punitive damages.

2009

The HITECH Act Jumpstarts Health IT: The American Recovery and Reinvestment Act of 2009 is enacted, which includes $19.2 billion in funding for the Health Information Technology for Economic and Clinical Health Act (HITECH) to subsidize and spur the use of electronic health records by physicians and hospitals. It also authorizes CMS meaningful use criteria for technology.

2010

Affordable Care Act and a New Age of Insurance Access: The Patient Protection and Affordable Care Act, also known as the Affordable Care Act (ACA), is signed into law by President Barack Obama in 2010, with an implementation date of 2012 for several of its provisions, and 2014 for the health exchanges. The ACA is responsible for spurring the formation of state health exchanges, regional health information exchanges, accountable care organizations, and patient-centered medical homes, as well as encouraging comparative effectiveness evaluations through the Patient-Centered Outcomes Research Institute.

2013

State Health Exchanges Operational: After a start riddled with technical problems, the federal government and more than 20 states open their health insurance exchanges to enrollees for the 2014 plan year. In April 2014, the Congressional Budget Office estimates that 12 million formerly uninsured Americans will have gained health insurance by the end of 2014 through the exchanges and expansion of state Medicaid programs.

2013

First Cohort Launches Boldly Into Bundling: Amid growing interest in value-based care, the CMS Innovation Center launches the Bundled Payments for Care Improvement (BPCI) initiative, which links payments for the many services received during a single episode of care so organizations can be held accountable for their performance on outcomes and cost. Participants assume financial liability for the entire spending episode, so they are incentivized to work closely across settings to deliver high-quality care.

2016

MACRA Final Rule Published: HHS finalizes the landmark Medicare Access and CHIP Reauthorization Act (MACRA), which reforms payment for Medicare providers and replaces the sustainable growth rate formula. Under MACRA, providers can dictate the pace at which they want to transition from fee for service to value-based care by choosing either advanced alternative payment models or the Merit-based Incentive Payment System.

2017

ACA Repeal Fails Dramatically: In the early hours of a memorable morning, Republican efforts to repeal and replace the ACA came to a seeming dead end as the so-called “skinny repeal” bill was voted down with 3 Republicans breaking ranks. The bill was a pared-down version of past efforts to repeal and replace the ACA and was thought to be the best chance of appeasing moderates. The bill would have eliminated some provisions of the ACA, like the individual mandate and fines, but largely left the ACA intact.

2020

COVID-19 Pandemic Wallops the World: In early 2020, a mysterious coronavirus-related pneumonia is reported in China, which soon explodes into a deadly global pandemic that disrupts health care delivery, employment, education, and almost every other facet of daily life. The trends specifically impacting managed care include a shift to virtual care via telemedicine, to limit in-person contact. There is a growth in Medicaid enrollment, as individuals could not lose eligibility during the public health emergency, and an increased recognition of the prevalence and severity of health disparities by race, ethnicity, socioeconomic status, and geography.

2023

Medicare Advantage Surges Ahead: In 2023, Medicare Advantage surpasses traditional Medicare such that more than half of eligible Medicare beneficiaries are now covered by one of these private plans, which offer expanded benefits and reduced risk of out-of-pocket expenses compared with traditional Medicare. As Medicare Advantage plans grow in popularity, more research is needed on their varying reimbursement rates, benefits, and financial impact on the government, health systems, insurers, and beneficiaries.

Testimonials

AJMC^® has had a unique opportunity in having a front row seat in the evolving health care environment over the last 30 years. It has been a lasting forum for bringing researchers, clinicians, health care executives and those directing health care policy together. AJMC gives the reader a snapshot of the major issues and challenges occurring in health care at the time.

Jan E. Berger, MD, MJ

President and CEO

Health Intelligence Partners

AJMC^® has been instrumental for showcasing important issues in health services and research delivery in the United States over the past decades, especially on the influences of health insurance and care delivery systems.

Rajesh Balkrishnan, PhD

Professor of Public Health Sciences

UVA School of Medicine

AJMC^® led the way in elevating pragmatic health services research that health care leaders can act on, which has helped normalize living in that space between tightly controlled experiments too far removed from daily realities, and anecdotal data. Neither has the journal’s thought leadership shied from tackling complex and uncomfortable issues.

Hoangmai (Mai) H. Pham, MD, MPH

President and CEO

Institute for Exceptional Care

A Message From Our Team

We're proud to be part of a team that knows it truly takes a village to bring each article, video, or event to life. Behind everything you see is a dedicated group of people who work tirelessly to deliver trusted research and impactful content. It's our passion for teamwork and our shared commitment to advancing health care that drives us forward every day. To you, our audience, thank you for inspiring us, challenging us, and being part of this incredible journey.

Latest Anniversary Coverage

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December 10th 2020

After 25 Years, AJMC® Looks to the Future: A Q&A With Michael E. Chernew, PhD, and A. Mark Fendrick, MD

By Michael E. Chernew, PhD
A. Mark Fendrick, MD

November 1st 2020

Medicare Advantage Providers, Patients Connect Without a Playbook: A Q&A With William H. Shrank, MD, MSHS

By Allison Inserro

September 24th 2020

Could COVID-19 Become a Policy Tipping Point? A Q&A With Kavita K. Patel, MD, MS

By Allison Inserro

September 10th 2020

Rebuilding the Ties of Public Health: A Q&A With Georges C. Benjamin, MD

By Allison Inserro

September 10th 2020

Dr Anthony Fauci Speaks to the Likelihood of Vaccines for HIV and COVID-19

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Our Impact by the Numbers	36,500+ Website Articles	8300+ Videos
7700+ Publication Articles	4800+ PubMed-Indexed Articles	970+ Issues*
	550+ Podcasts	Metrics account for published content between 1995-2024. Issues include The American Journal of Managed Care®, The American Journal of Accountable Care®, Population Health Equity & Outcomes, and Evidence-Based Oncology®*.