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Searcher Jul/Aug 2010 Tara Breton	What's in the Patient's Medical Bill? If you want more understanding of medical billing, here are the basics of the U.S. medical reimbursement system that will hopefully assist you along with web resources on this subject.
Managed Care January 2008 Peter Kongstvedt	The Managed Care Forecast Here are some of the challenges that health insurers face this year.
Managed Care July 2007 Tom Reinke	Better Ways to Pay Providers Paying for coordinating care and for packages of services -- bundling and episodes of care -- may be the best bet for a modification of the unfettered fee-for-service system.
Managed Care January 2008 Marcia Naveh	Lax Coding by Physicians Hurts Medicare Advantage Plans By assisting doctors, insurers can get all the payment that they are due, but that too often is lost.
Managed Care December 2000 Michael Levin-Epstein	Outpatient PPS Regulations Latest Source of Anti-HCFA Anger The Health Care Financing Administration continues to be one of the most besieged agencies in the federal government. Now, providers are attacking the agency's rules for the prospective payment system (PPS) for hospital outpatient services...
Pharmaceutical Executive May 1, 2005 Erik Felker	Elephant or Specialist? The Bush Administration has put in place the groundwork for new market forces that will forever change how pharmaceuticals are commercialized. Although the long-term impact of this change is not known, unprepared companies are at a serious disadvantage.
Nursing Management April 2009 Sharon H. Pappas	Profits, Payers, and Patients: Responding to Changes Profit is necessary for hospitals to fulfill their missions, invest in expansion and new technologies, and reinvest in existing patient care infrastructures. Profitability is the work of the financial team and the clinical team to produce the hospital's desired financial outcome.
Managed Care March 2005 Michael S. Victoroff	Current Billing System Fosters Error, Dishonesty If clinical mistakes were as common as clerical ones, nobody would leave a hospital alive. Something needs to be done, and done soon.
Managed Care March 2006 Taylor & Eck	It's Time for CMS to Release Physician Medicare Claim Information The Center for Medicare & Medicaid Services is a rich source of price and quality data. Isn't it about time it shared that data?
Pharmaceutical Executive August 1, 2012 Debbie Warner	Adapting to a New Era of Cancer Care Coverage and treatment decisions will be driven by value and defined differently by each stakeholder.
Managed Care December 2006 MargaretAnn Cross	Confronting The Medicare Cost Shift Plans are increasingly concerned about the degree to which providers overcharge them to make up for losses from government programs.
Pharmaceutical Executive June 1, 2005 Jill Wechsler	Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs.
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 2007 Martin Sipkoff	Hospitals Asked To Account For Errors on Their Watch Centers for Medicare & Medicaid Services and states may stop paying for specific hospital-acquired conditions. Will health plans follow suit?
The Motley Fool January 22, 2007 Dan Caplinger	Understanding Medicare: Benefits Medical coverage for seniors is a big part of a strong retirement-protection plan.
Managed Care August 2007 Martin Sipkoff	Soaring Price of Cancer Drugs Leads Plans To New Approaches Insurers are trying different methods, from pay for performance to promoting preventive care, to hold down cost of chemotherapy drugs.
Managed Care November 2001	Medicare+Choice Problems Chasing Away 58 Health Plans Medicare+Choice, the program that was supposed to ease the elderly into managed care, is itself suffering from the uneasiness of HMOs dissatisfied with payment rates...
Searcher October 2011 Stephanie C. Ardito	The Medical Digital: Navigating the Medicare Maze Since entitlement programs are the chief governmental programs under fire, I decided to revisit the healthcare bills passed back in March (H.R. 3590, the Patient Protection & Affordable Care Act).
Nursing Management September 2008 Richard Hader	Strategies for profitable growth Experience has demonstrated that a focus on expense reduction alone won't sustain or improve financial stability in health care services.
American Family Physician September 15, 2006 Liz Smith	Newsletter CMS Issues Guidance on Part D vs. Part B Coverage Determination... Residents, Students Adopt Resolutions on Drug Samples, Universal Care... CMS Proposes Changes to Outpatient Services Policies and Payment... etc.
Pharmaceutical Executive December 1, 2006 Rod Cavin	Forecasting Medicare: Price Controls in the Years Ahead Part D in 2010 will be under price and access pressure. Pharma should develop plans for the future by imagining best- and worst-case scenarios.
Financial Planning April 1, 2007 Joan Warner	What's Next for Medicare Is America's retirement healthcare plan really in trouble? Here's some good news -- and some hard decisions for your financial advisory clients.
Financial Planning April 1, 2010 Donald Jay Korn	Medicare: Change is Coming This is a great time to get together with clients over 65 who will be affected by health care changes and go over their Medicare coverage. At the same time, you can see what other areas of financial planning are on their mind.
The Motley Fool January 27, 2009 Devon Rackle	Almost Family Almost Makes the Cut Shares of home health provider Almost Family have risen eightfold in the past five years, but you still might want to stay away for the time being.
Managed Care March 2008	CMS Hybrid Payment System Shows Promise Combining Medicare fee-for-service payments with new incentive programs could help physician groups save money for Medicare and reach quality-of-care targets.
The Motley Fool January 22, 2007 Dan Caplinger	Understanding Medicare: Claims In general, Medicare provides a level of coverage that is fairly similar to what private health insurance plans offer. Here are some tips for getting the most from it.
Managed Care May 2006 John Carroll	Medicare Debates Fairness of Pay For Primary Care and Specialists A growing controversy in MedPAC and in physician organizations could spill over into how all health plans compensate doctors.
Managed Care October 2007 John Carroll	Medicare Coverage Rules Are Not Always Last Word Yes, commercial health insurers often take a cue from the government, but that doesn't mean that they follow blindly.
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?
Financial Planning November 1, 2007 Donald Jay Korn	Medicare Choices What are Medicare private fee-for-service plans and why did their fortunes rise and fall so dramatically? Most important, if these plans survive in their current form, should advisors suggest them for clients enrolled in or approaching Medicare eligibility?
CFO January 1, 2002 Andrew Osterland	Operating Room Rising hospital costs, a plague to most companies, have helped some health-care CFOs nurse profits back to health.
Managed Care May 2002 Patrick Mullen	Interview: Thomas Scilly In a candid, wide-ranging interview, the Centers for Medicare and Medicaid Services administrator counsels patience in solving the myriad problems of health care. A fix could take 20 years
Managed Care September 2002	Medicare holds down physician pay Compensation increased at a comparatively small rate from 2000 to 2001 for both primary care physicians and specialists, according to the Medical Group Management Association.
BusinessWeek January 7, 2010 Catherine Arnst	Hospitals: Radical Cost Surgery A hospital that slashes costs - and delivers high-quality care as it innovates? Yes, it exists.
Managed Care April 2007	Consumers Upset By High Cost of Administration When it comes to health care administrations, there is a wide gap between what executives of hospitals and insurance companies believe it costs and what consumers believe.
Managed Care August 2006 Emad Rizk	Finding Opportunity Where Business Models Meet The next stage of payer-provider collaboration will add true value.
Managed Care October 2003 Ed Silverman	Tough Negotiations in Store Between Plans and Hospitals Fallout from the Medicare outlier-payment scandal is likely to force hospitals to try to replace that revenue. Health plans, prepare to negotiate!
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 July 2007 John Carroll	Unlocking a Trove of Quality Data A bill before Congress would give analysts a powerful tool for sifting through Medicare data on the performance of hospitals and physicians.
Managed Care December 2007 John Carroll	How Doctors Are Paid Now, And Why It Has to Change Everyone knows about the perverse incentive of fee-for-service medicine, but that hasn't had much effect on its use.
American Family Physician November 15, 2006 Liz Smith	Newsletter AAFP adopts new physician workforce policy to counter family physicians shortage... Medicare and Medicaid services propose allowing use of part D data for research initiatives... etc.
The Motley Fool November 10, 2005 David Braze	Who Pays for Long-Term Care? In the second of a six-part series, this installment covers what Medicare and Medicaid cover (and don't cover) for long-term care.
Registered Rep. January 2, 2013 Kevin McKinley	Mapping the Medicare Maze Advisors can shed some much-appreciated light on this crucial but confusing program.
Pharmaceutical Executive November 1, 2013	Roundtable on Market Access Market Access is a window on what matters in the real world of soaring patient expectations and crimped payer budgets for innovation.
American Family Physician January 15, 2007	Newsletter Congress Passes Legislation That Prevents Medicare Payment Cut... Congress Approves Extension of Physicians for Underserved Areas Act... HHS Unveils Four Cornerstones of Value-Driven Health Care System... etc.
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 2007 John Carroll	Democratic Agenda Places Medicare Advantage at Risk Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split.
Managed Care May 2006 Michael Levin-Epstein	Looking for a Better Way To Manage Care Can primary care physicians persuade health plans and Medicare to accept their version of the chronic care model?
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 November 2004 Frank Diamond	DM's Cost-Effectiveness Doubted in CBO Report Congress's financial review agency says that not enough evidence exists to prove that disease management saves money. Many beg to differ.