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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?
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 May 2002	Primary Care Suffers Under M+C, Study Says Medicare+Choice compares unfavorably with traditional fee-for-service Medicare in 9 out of 11 features linked to primary care, according to a study funded by the U.S. Agency for Healthcare Research and Quality that is generating interest and controversy
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care March 2007	Use of Generics On the Rise Recent data indicate that generic medication accounts for nearly 60% of the drugs dispensed to people in Medicare Prescription Drug Plans and Medicare Advantage plans.
Managed Care February 2005	Different methods used to gauge doc performance Just how physician performance is measured has become more important as P4P programs proliferate.
Managed Care April 2006	Pay-for-Performance Champions Excited by California Program's Success A quality incentive program in California is yielding results that could be replicated in Medicare and other pay-for-performance (P4P) programs nationwide according to a new report.
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.
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 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...
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.
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.
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 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 February 2006	Managed Care Offered to More Medicaid Enrollees A chart illustrates the percentage of medicaid enrollees in managed care, for the years 1996 to 2004.
Managed Care July 2004	Headlines On Deadline ... In a major victory for HMOs, the Supreme Court voted unanimously on June 21 that patients may not sue health plans in state courts for refusing to pay for medical care recommended by physicians.
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 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 February 2005	Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.
Managed Care December 2006	Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.
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 May 2003	Program Rewards Physicians For Delivering High-Quality Care Bonuses for delivering high quality care will be the focus of a three-market program spearheaded by the National Committee for Quality Assurance and supported by a coalition of physicians, health plans, large employers, and the Centers for Medicare and Medicaid Services.
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 September 2007 John Carroll	Who Gets Covered, Junior or Grandma? America's Health Insurance Plans is mounting a very public campaign aimed at portraying a House bill as a measure that robs enrollees of essential benefits.
Managed Care May 2007 MargaretAnn Cross	Following the Leaders Top pay-for-performance programs point to increased focus on hospital incentives, efficiency measures, coordination, and standardization.
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.
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).
Managed Care August 2001	GAO: Consultants Point Docs Toward Federal Law Violations The General Accounting Office has found that some health care consultants have been advising physicians to do things that conflict with federal laws and that may be unethical...
Managed Care July 2007	AMA: Patients Will Feel Cuts in Medicare Next year's proposed 10 percent cut in Medicare payments is serving as a rallying point for members of the American Medical Association, which says the cuts will make it difficult for physicians to accept new Medicare patients.
Managed Care April 2005 Frank Diamond	Starting Medicare Advantage Plan Brings Special Set of Problems The feds will help you launch a health plan for the elderly, but just what does it take to get something like this operating in so short a time?
Managed Care October 2005	Headlines On Deadline ... Defensive medicine is something the public seems to be very aware of... Pay-for-performance initiatives got a boost...
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 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...
Managed Care April 2006 John Carroll	Some Specialist Societies Feel Left Out of AMA-CMS Deal on P4P Many physicians question the fairness of a deal between the American Medical Association and the government that give doctors a bonus when they follow certain rules.
Managed Care September 2006 John Carroll	Managed Medicare Revitalized: Feel-Good Plan of the Decade Insurers are largely happy with what they've seen. They're creating new benefit packages and expect more business in the next one to three years.
BusinessWeek October 10, 2005 Howard Gleckman	Medicare's Big Experiment The coming changes to Medicare aim to cut costs while improving care. Sound familiar?
Managed Care March 2006	Standard Measures In Works For P4P Push Uncle Sam has decided to get behind the pay-for-performance effort in a big way, something some physician associations are less than thrilled about.
The Motley Fool July 1, 2011 Luke Timmerman	Dendreon Sways Medicare to Pay for Prostate Cancer Drug The decision by Medicare is no surprise, but it does conclude a period of uncertainty about insurance reimbursement for its lone marketed product.
Managed Care February 2002	Hospital costs lead way in health care expenditures The share of the gross domestic product attributed to health care increased slightly more than overall GDP growth from 1999 to 2000 -- the first time that's happened in nine years...
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 February 2006	Medicare's Efficiency Over-Hyped, Study Claims The belief that Medicare is a more efficient system than employee-sponsored health insurance comes under fire in a study that claims there are hidden costs in the government program.
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 July 2005 Martin Sipkoff	Is Pay for Performance Part of the Cure or the Problem? Paying for performance promises improved quality, reduced cost, and higher income for doctors. So why are some of them worried?
The Motley Fool February 24, 2009 Brian Orelli	Health Insurers Hammered. Again. Health insurers were blown away by the Centers for Medicare and Medicaid Services' announcement that it plans to raise the 2010 Medicare Advantage payment rates by only 0.5%.
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.
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 September 2003	Medicare+Choice expenses increasing for enrollees Those who argue that Medicare and managed care don't mix well have new data to take to the fight. A Commonwealth Fund report states that the average out-of-pocket costs for Medicare+Choice enrollees soared 10 percent this year.
Managed Care October 2001 Michael Levin-Epstein	Medicare+Choice Reform: Hope, but No Quick Action Expected There have been small accomplishments, and wheels have been churning for more forceful action -- that is, they were until Sept. 11...
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.
Financial Planning July 1, 2006 Robert M. Hayes	Preserve Medicare Medicare is a roadmap for the future healthcare of America. It should be fine-tuned and improved, not undermined and privatized as the Washington power brokers are now attempting to do.