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Managed Care October 2005 Bob Carlson	What Docs Hate Most About Plans Some insurers seem to have a knack for irritating their network physicians. The list is long, but five categories of irritants seem to recur most often.
Managed Care January 2007	Change From Salary to Relative Value Units Leads to Higher Income for Physicians A Minnesota medical group that contracted with HealthPartners was able to improve cost of care, physician compensation, and patient access without harming patient satisfaction when the group converted from a salary payment system for physicians to one solely dependent on physician productivity.
Managed Care July 2001 Harry L. Leider	HMOs Need To Share Gains of DM Programs Physicians are more likely to buy in if they see better outcomes -- and financial rewards that go with them...
Managed Care August 2002 Joyce Ochs	Managed Care's Use of Web Not Just for Marketing Anymore Virtually all MCOs today have Web sites as a matter of course. The challenge is to have a site useful enough to make people come back, while the operating challenge is to transfer selected company functions entirely or partially to the Internet to increase efficiency and reduce expenses.
Managed Care October 2003 John L. Phelan	Pay Incentives to Physicians For Filing Electronic Claims Physicians' well-known reluctance to invest in office computer hardware and software is costing health plans money. How to get the docs' attention?
Managed Care September 2004 Tony Berberabe	Can Physician and Health Plan Get Together Over Guidelines? Physicians are not the only problem. Health plans too often view guidelines as rigid routines rather than flexible aids to good practice.
Managed Care October 2007 Lola Butcher	Can Insurer, Oncology Practice Really Work Together? Premera Blue Cross and a large Spokane oncology practice agree on treatment protocols and on the importance of cost control.
Managed Care March 2000	Tracking the Tracker of Health Care's Trends The president of the Medical Group Management Association encourages changes that would bring physician practice and medical record-keeping in step with the times, and decries the lack of medical standards across plans.
Managed Care June 2001 Bob Carlson	Prompt-Payment Laws Don't Get to Heart of Matter "What we've got here is a failure to communicate," says Strother Martin as the captain in Cool Hand Luke. He's talking about the prisoner Luke, played by Paul Newman -- but he could just as well be explaining why it's so hard for physicians to get their claims paid...
Managed Care March 2007 Martin Sipkoff	Plans, PBMs, Employers Prod Docs To E-Prescribe Widespread adoption of electronic prescribing is inevitable, yet physicians still resist. Various coalitions and initiatives are trying to make adoption easier.
Managed Care October 2007	Family Physicians Give Payers Middling Grades Results of a survey conducted by the American Academy of Family Physicians and Family Practice Management magazine indicate that health plans have issues to work on.
Managed Care June 2007	Docs Don't Exploit Electronic Prescribing While physicians were positive about the basic features of e-prescribing, products often lacked advanced features, or if they had them, physicians often did not use them because of implementation hurdles or their perceptions that the features did not add value.
Pharmaceutical Executive May 1, 2006 Musacchio & Hunkler	More Than a Game of Keep Away The Prescribing Data Restriction Program takes effect in July. The AMA explains how individual doctors can keep their prescribing habits safe from reps, and how pharma can keep using the anonymous data -- if the industry polices itself.
Managed Care May 2007 David A. Sparrow	Pay for Performance: As Much About Costs as About Quality You don't really have a true pay-for-performance program if it doesn't say so on the bottom line.
Managed Care July 2007	Managed Care Outlook The future holds too few docs.
Managed Care January 2005 Alice G. Gosfield	P4P: Transitional at Best Pay-for-performance (P4P) programs promise a fair shake for provider and insurance plan, but a former chairman of the National Committee for Quality Assurance sees many design flaws to overcome.
Managed Care September 1999 Bruce J. Goldstein, J.D. & Mark D. Abruzzo, J.D.	Health Plans That Decredential Docs Must Do It Correctly and Expect a Fight
Managed Care April 2000	With AMAP Gone, Quality Judgments In Hands of Others When the American Medical Association shut down its physician accreditation program, AMAP, last month, several physician leaders expressed concern that the profession had lost its best chance to demonstrate efficient, high-quality care....
Managed Care June 2004 Tony Berberabe	Welcome to the Brave, New (Electronic) World, Doctor WellPoint is providing free handheld or even desktop computers in an effort toward minimizing medication errors. Will docs finally abandon pen and pad?
Managed Care March 2001 Frank Diamond	Don't Be Misled by the Hype: Credentialing -- Important, but Difficult HMOs may be trying harder, but PPOs seem less interested. Then there's the whole issue of credentialing's relationship to the licensure process...
Managed Care April 2000 Karen L. Trespacz, J.D.	League of Their Own: What Makes a Winning IPA? In a familiar cartoon, a professor writes long, learned equations on a blackboard. To connect the profundities on either end, he writes in the middle, "Then a miracle occurs." IPAs, done well, are the miracles that connect the ends of health care.
Managed Care May 2004 MargaretAnn Cross	Will Providers Seek New Contracts As Consumer-Directed Plans Grow? Although plans are not restructuring fee schedules in consumer-directed health plans, providers think their agreements need fine-tuning.
Managed Care June 2001 Frank Diamond	HMO/Physician Strain Creates Invisible Costs Perhaps goodwill is too much to ask for. However, peaceful coexistence can certainly help all players reach their mutual goal -- a smooth relationship that helps to get the job done...
Managed Care February 2001	Denver Docs Bolt Aetna Before It Ends 'All-Products' Some 8,000 Denver-area residents were left to find new doctors when 240 physicians affiliated with MedWest Medical Group dropped Aetna U.S. Healthcare in a dispute over contract terms. The doctors did not renew their Aetna contract when it expired Jan. 31...
Managed Care June 2007	Headlines On Deadline ... NCQA has published an expanded set of measures, guidelines, and technical specifications...A new strategy proposed by America's Health Insurance Plans would create an independent entity to compare the safety... etc.
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.
Managed Care October 2007	Data on Quality Lacking for Docs A new report says that insurers are better at providing quality information about hospitals than about physicians.
Managed Care May 2004 Martin Sipkoff	Will Pay for Performance Programs Introduce a New Set of Problems? Paying incentives to physicians to practice evidence-based medicine appears to be an idea whose time has come. Such programs -- even if successful -- may create a new set of problems.
Managed Care January 2002 Ed Rabinowitz	When Physicians' Skills Fail, Collaboration Beats Punishment New programs hold promise for rehabilitating sound physicians who have, for any number of reasons, lost some of the skills they started with...
Managed Care August 2001	In Calif., Bonuses Based on Quality, Not Cost Savings Blue Cross of California has decided to move away from the traditional managed care incentive of rewarding physicians for controlling medical costs, and instead will implement a program in which physicians receive bonuses for quality of care and patient satisfaction...
Managed Care August 2000 Bob Carlson	'All Products' Clauses Fade From Physician Contracts All-products provisions in health plan provider contracts are slowly being negotiated, legislated, and regulated out of existence. They are now illegal in at least four states; legislation is pending in several others.
Managed Care April 2007	A Conversation With Emad Rizk, MD: Disease Management Beyond the Call Center The man who heads McKesson Health Solutions, the third largest disease management program in the country, says it's time to roll out a new model.
Pharmaceutical Executive September 1, 2013 Shantanu Agrawal	Making Sense of the Sunshine Act: A New Era for Drug Promotion Now that the Sunshine Act's Open Payments spending disclosure program is live, the federal government's lead officer for compliance explains how the new web-based system will work and how US industry, providers, and patients will be better off by making their relationships fully transparent.
Managed Care June 2005 Martin Sipkoff	The Re-Emergence of the Primary Care Physician A new model of care developed by the American Academy of Family Physicians places primary care physicians back at the center of care delivery.
Managed Care January 2006	Compensation Monitor A recent poll reveals that doctors distrust pay for performance programs.
Pharmaceutical Executive April 1, 2012	Medical Meetings: Docs Speak Out Three physicians took the stage at the fourth annual West Coast Life Sciences Meeting Management Forum to explain their perspective on healthcare reform, online versus live education, and more.
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.
Pharmaceutical Executive January 1, 2013 Al Topin	The Doctor-Patient Disconnect Doctor-patient conversations aren't always what we think; this basic interaction represents both a problem and an opportunity for today's drug marketers, says the author.
Managed Care October 2000 Maureen Glabman	Giving Some Ground to Physicians Helped Turn Health System Around One hospital system accepted the general wisdom a few years ago by acquiring physician practices. Now it bucks the new wisdom by holding on to them...
Insurance & Technology November 14, 2007 Karen Ignagni	Technology, Innovation Enable Health Insurers To Address Challenges The health insurance industry will continue to innovate and provide new tools to improve the quality of care and contain costs while working with government leaders to ensure Americans have greater access to affordable coverage.
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?
Pharmaceutical Executive May 1, 2005 Ame Wadler	PR: In the Loop Pharma marketers can help doctors stay abreast of the news.
Managed Care November 1999 Peter I. Juhn, M.D.	An Evidence-Based Approach To Care Depends on All Parties -- Physicians Included ...transforming the delivery of care into a systematic approach that is based on the best medical evidence -- is dependent on more than just laying out the rules...
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 June 2007 MargaretAnn Cross	What the Primary Care Physician Shortage Means for Health Plans Insurers fear rising costs and poorer outcomes if members are less able to get appointments with family physicians and general internists.
Managed Care October 2004 Tony Schueth	Formulary Standards Key To E-Prescribing Success Electronic prescribing needs standardization before it's adopted by the masses. Start with the format of formulary databases.
Managed Care May 2000	Texas-Aetna Incentives Settlement Worries Some Capitated Physicians If the Texas deal ignites a trend away from the use of incentives to keep utilization down, then some capitated physicians worry it will put them in a tight spot.
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.
Pharmaceutical Executive October 1, 2010	When the Payer IS the Player As Medicare, Medicaid, and the nation's web of private payers gain market power, how can pharma stay ahead of the cost-containment curve?
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.