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Managed Care
December 2000 |
Headlines on Deadline... Physician fees under Medicare will go up an average of 4.5 percent next year... The number of HMOs participating in the Federal Employees Health Benefits Plan dropped by 40 percent... The California Public Employees' Retirement System has seen a 40-percent increase in medical costs... etc.   |
Managed Care
November 2000 |
For first time ever, HMO enrollment drops in 1999 National HMO enrollment fell by 400,000 last year, from its all-time high of 81.3 million. For at least two years, a wider array of managed care products and an ever-smaller pool of people still covered under indemnity plans slowed the rate of HMO enrollment growth... |
Managed Care
July 2000
Michael Levin-Epstein |
Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen. |
Managed Care
October 2000 |
Large HMOs Do Well While Small Ones Slide Weiss Ratings reports that the nation's HMOs lost a collective $187 million during 1999, despite the positive performance of most of the country's largest managed care organizations... |
Managed Care
November 1999 |
Medicare Reform Dead for Now On Capitol Hill |
Managed Care
November 1999
Richard Hamer |
Goals 2000: For HMOs: Administrative Retooling For MDs: Managerial Competency ...While HMOs retrench, physicians need to become more constructive participants.... |
Managed Care
November 1999
Uwe Reinhardt, Ph.D. |
Defined Contributions Will Point Employees Toward 'Health Marts' Companies will want to distance themselves from insurance entanglements, giving employees little option but to become more involved.... |
Managed Care
January 2001 |
Study: Elderly Exit When They Exceed Rx Benefit Cap In a study that confirms what has long been assumed, Medicare HMO enrollees become more likely to drop their carriers when they exceed annual pharmacy-benefit caps... |
Managed Care
December 2002 |
California Puts Doctor Scores On Report Cards The competency of physician groups is often as important as HMO performance in determining patient outcomes, California health regulators have decided |
Managed Care
June 2001 |
Few Seem To Use POS Option To Go Out of Network Point-of-service plans, in which members can see an out-of-network provider for higher out-of-pocket cost, are among the options employers offer with increasing frequency... |
Managed Care
January 2001
David Ricks & Joe Suminski |
Nowhere To Go but Out? Tracking Medicare+Choice Managed Medicare's trouble may have something to do with underfunding or rich benefits, but for health plans, market share has a lot to do with it, too... |
Managed Care
October 2003
MargaretAnn Cross |
Some HMOs See Dividends In Charging Deductibles This may be one way to regain profitability, though getting permission from government regulators may take some doing. |
Managed Care
August 2000 |
With Cost Study, Group Argues For OTC Benefit A study by HECON Associates, a Maryland-based market research group, supports the claim that when prescription drugs become available over the counter, consumers face increased out-of-pocket costs. |
Managed Care
January 2001 |
More HMOs to fold, consolidate in 2001 More than six dozen HMOs have characteristics that put them in danger of going out of business, according to projections by InterStudy publications... |
Managed Care
January 2001 |
When pressure's on, raises get better In this tight labor market, most large companies are offering competitive salaries to recruit top talent, while making pay raises attractive enough to retain good employees who are knowledgeable about the organization. This is, perhaps, doubly true for managed care organizations... |
Managed Care
March 2002
Charles Downey |
The Department of Managed Care California sets a precedent again, with a bold effort to regulate the HMO industry. While the new Department of Managed Health Care is facing down 50,000 consumer gripes monthly, director Daniel Zingale intends to keep administrative red tape from overwhelming everyone... |
Insurance & Technology
April 4, 2007 |
IBC Names Carolyn Luther SVP, IS Luther assumes the top technology post after holding leadership positions at Independence Blue Cross since 1990. One of the largest initiatives she will focus on is the creation of a consolidated rating engine for use across both large and small markets. |
InternetNews
August 5, 2010 |
Another Laptop Theft Exposes 21K Patients' Data Philadelphia's Thomas Jefferson University Hospital is in the process of notifying more than 21,000 patients that a stolen laptop has exposed some of their most sensitive personal information. |
Managed Care
November 1999
Michael D. Dalzell Senior Editor |
HMOs, Physicians Discover They Really Need Each Other Some HMOs may be more willing than you think to help financially troubled medical groups survive. A willingness to cooperate is key. |
Managed Care
April 2002
Frank Diamond |
Medicare+Choice: Uncertain Future for Unstable Program While policy makers haggle over President Bush's budget request for the system, an ominous question looms: Can money solve all the problems? |
| Knowledge@Wharton |
Major Health Care Reform Under President Bush Remains Elusive Three of the chief health-care challenges facing the United States are: finding a way to provide coverage for the millions of uninsured, reforming Medicare, and setting up a prescription-drug plan for the elderly. The White House is likely to make headway on only the third of these in the next two years. |
| Knowledge@Wharton |
Prescription Drug Coverage for Seniors Faces Uncertain Future The discussion about adding a prescription drug benefit to Medicare will be put on hold... |
Managed Care
July 2000
Neville M. Bilimoria, J.D. |
HMOs Continue Losing Ground On Liability Issues at State Level The recent U.S. Supreme Court decision offers a nice breather, but executives should not let down their guard, as an Illinois ruling shows. |
Managed Care
February 2002 |
Industry Braces for Fallout From Docs' Malpractice Woes Malpractice insurance premiums are going up so quickly that many physicians are feeling pressure to stop offering certain procedures, to move to states that are friendlier to medical practices, or even to retire early... |
Managed Care
July 2002
John A. Marcille |
Capitation as Whipping Boy: Court Takes on Touchy Issue If plans are to keep coverage decisions reasonable and fair, they'll need tools that involve physicians and patients in the decision-making process. Capitation is one of those. |
Managed Care
May 2002
Sharon Baker |
Self-Funded HMOs on the Rise Escalating premiums, changing attitudes play a role in employers' decision to take on the same thing that burned many physicians: financial risk |
Managed Care
June 2002
Jeffry R. Ellis |
Third-Party Payers Don't Realize Burdens Placed on Pharmacists PBMs and HMOs, by imposing a workload that doesn't allow enough time for needed functions, seem to want pharmacists to fail, this author asserts. |
Managed Care
December 2006 |
Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs. |
Managed Care
September 2005 |
HMO Profits up, But at a Much Slower Rate Overall, the HMOs' profits increased 10.7 percent in 2004, according to data collected from 515 managed care organizations. |
Managed Care
November 1999
Margaret E. O'Kane |
Quality-Measurement Organizations Look Beyond HMO and POS Plans Now that the hard part -- forging quality-measurement systems for HMOs and point-of-service plans -- has been done, the next step is to adapt these programs to the rest of the health care industry.... |
Managed Care
February 2001 |
In Medicare Bill, HMOs Got What They Wanted When the dust cleared over how $35 billion in Medicare "givebacks" would be divided, the Republicans prevailed -- Medicare HMOs got a bigger cut than Democrats wanted to give them. Now, President Bush may be poised to give Medicare managed care plans more... |
Managed Care
July 2000 |
Are Gatekeepers Failing To Control Specialty Costs? The importance of a gatekeeper in keeping costs down has been challenged again -- this time in a study that compares physician utilization for HMOs and point-of-service plans. |
Managed Care
November 1999 |
U.S. Supreme Court To Hear Suit Against HMOs Over Incentives Can HMOs be sued for the practice of offering bonuses to physicians who help them keep the cost of care down?... |
Managed Care
March 2000
Mark D. Abruzzo |
Beating Obesity Begins By Expanding Tort Reform It's been suggested that, in order to battle obesity, HMOs should use their collective information and knowledge to change their members' behavior.... |
