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Managed Care
June 2003 |
For-profit, not-for-profit enrollment holding about steady While HMOs seemed to be losing enrollees to PPOs, the ratio of enrollees in for-profit and not-for-profit HMOs stabilized in the late 1990s, according to data collected by the Centers for Medicare and Medicaid Services.   |
Managed Care
December 2006 |
NCQA Rankings Give Edge to Not-For-Profit Insurers No sooner had the quality rankings of health plans in the nation, as measured by the National Committee for Quality Assurance, been released then it was pointed out that most of the top performers were not-for-profit insurers. |
Managed Care
April 2000 |
Financial Stability Of HMOs Called A Mixed Bag An HCIA-Sachs survey says the median HMO profit margin in 1998 was -1.7 percent, slightly better than in 1997. Forty-one percent of HMOs made money in 1998.... |
Managed Care
December 2002 |
Drug-discount program's effectiveness hindered by lack of use California offers a prescription drug discount program that allows Medicare beneficiaries to get discounts just by showing their Medicare cards to pharmacists. Unfortunately, a majority of those eligible -- both those with and without drug coverage -- have never heard of the program. |
Managed Care
September 2004 |
Bush Officials Seek Bounce From Medicare Reform Law Unfortunately for Bush, a recent survey says that most Medicare recipients who plan to let this issue influence their vote plan to cast those votes for Sen. John Kerry. |
Managed Care
October 2002 |
Though M+C Erosion Slows, Reimbursement Still an Issue The exodus of health plans from Medicare+Choice will moderate somewhat next year, offering hope that the struggling system can make a comeback. |
Managed Care
February 2004
John A. Marcille |
The Administration Delivers A Major Gift to Managed Care Which brings me to the announcement that Medicare payments to health plans participating in what was called Medicare+Choice but is now known as MedicareAdvantage will increase by a record 10.6 percent. |
Managed Care
December 2006 |
Medicare Part D Recipients Plan to Stay with Coverage Seventy-three percent of people in Medicare Advantage prescription drug plans want to stick with their current coverage package in 2007, according to a Wall Street Journal/Harris Interactive poll. |
Managed Care
October 2000 |
Quick Fix May Be in Store for M+C, But Meaningful Change Likely To Wait Whatever diversion prescription drug proposals have provided, Medicare+Choice is back on Congress's radar screen. While sentiment is again running strong among legislators to address the wounded program, Congress is now racing a clock ticking ever closer to the elections... |
Managed Care
March 2002 |
How Medicare beneficiaries spend money on drugs The Kaiser Family Foundation notes that Medicare beneficiaries account for 14 percent of the U.S. population, but for 43 percent of the nation's spending on prescription drugs. Thirteen percent of beneficiaries had to pay $2,000 or more out of pocket in 2001... |
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
February 2004
John Carroll |
New Medicare Risk Adjustments Bad News for Unprepared HMOs Getting less-than-hale elderly enrolled can finally be a sound business strategy for HMOs that comprehend the new rules and have sufficient IT capability. |
Managed Care
March 2002 |
M+C Enrollees Bound to Their Choice Until June A lock-in mechanism for Medicare+Choice that kicked in Jan. 1 narrows the period during which enrollees can switch from health plan to health plan... |
Managed Care
December 2004 |
Headlines On Deadline ... Preferred Provider Organizations participating in Medicare Advantage can satisfy federal oversight requirements if they've already received accreditation from the National Committee for Quality Assurance. |
Managed Care
July 2002 |
Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1. |
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? |
Managed Care
November 2003 |
Industry profits seen rising again in 2004 The managed care industry is poised for a strong 2004, with profits projected to increase at least 16 percent, according to preliminary findings from "The Outlook for Managed Care, 2004," a report prepared by Corporate Research Group, a health care publisher. |
Managed Care
May 2007
Frank Diamond |
Medicare Advantage Hits Jackpot with Private Fee-for-Service Plans The secret to the success of Medicare private fee-for-service plans is as old as gold. Will beneficiary satisfaction force Congress to keep the faucet turned on? |
Managed Care
July 2002 |
Survey: Health System Changes Should Not Be Made Too Quickly A sweeping change to the American health care industry, such as a wholesale move to a system based on defined contribution, is not favored by most people, according to a national survey that seems to reflect a conservative mood regarding medical coverage and prescription drug benefits. |
Managed Care
September 2003 |
Anthem Blocked In Bid To Buy BCBS of Kansas The consolidation of member plans in the Blue Cross and Blue Shield Association has hit yet another snag. The Kansas Supreme Court on Aug. 6 upheld an order blocking the $190 million sale of the not-for-profit Blue Cross and Blue Shield of Kansas to Anthem, a for-profit operation. |
