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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 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 November 1999 Steve Wetzell	To Cure Risk Aversion, Employers Eye Risk Adjustment ...The more employers can get consumers involved in the game, the more providers will become directly accountable to consumers. Under traditional managed care, employers -- without realizing it -- have put themselves in the middle of the relationship between physicians and their patients...
Managed Care November 1999 Karen Ignagni	Health Plans Will Use New Tools To Help Physicians Practice Better For the first time, plans are in a position to work with physicians to improve outcomes, efficiency, and patient safety....
Managed Care November 1999 Al Lewis	Irresistible Force Called DM Facing Some Immovable Objects Disease Management
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 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 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 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 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 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 January 2001 Frank Diamond	Blueprint for the Future? Or Trapped in a Lockbox? The Federal Employees Health Benefits program has been touted as the way managed care is supposed to look. Expanding it, however, may not be feasible...
Managed Care April 2001 Frank Diamond	Why HMOs Could Thrive In the Economic Downturn It happened in the slump of the early 1990s, and it could very well happen again. Managed care feasts while other industries starve. People will still get sick, even in bad times...
Managed Care January 2004	Large Employers Now Use DM To Cut Their Costs Employers are adopting disease management programs in a big way to slow the pace of health care premium increases, according to a survey of 3,000 businesses.
Managed Care September 2002 Patrick Mullen	Interview: Richard L. Hamer Market-research organization InterStudy's director says that the push for patients' rights has grown into a concern for quality directed mainly at doctors.
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 July 2002 Frank Diamond	Premium Hikes: No Cause for Celebration Lost market share and further erosion of public trust will be the long-term by-products of this short-term solution.
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 John A. Marcille	Change Is To Be Expected, But Not Always Welcomed The biggest threat to managed care as now practiced may be this new scheme, defined contribution. Even more than the Patients' Bill of Rights, this is a movement that could shake the industry...
Managed Care February 2001 Frank Diamond	Defined Contribution: Why It Won't Happen Any Time Soon There's a difference between plausibility and wishful thinking that many who predict the advent of this system fail to recognize. Risk adjusting, adverse selection, and the tax code present hurdles...
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 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...
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 October 2001 Frank Diamond	Indirect Costs: Asking plans to keep employees on the job Employers in revolt against fast-rising premiums could ask HMOs to pay more attention to time-loss management. NCQA's interest may encourage this approach...
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...
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.
Managed Care November 2003	Study Says PPOs Don't Mix Well With Medicare Despite the will and wishes of many members of Congress, Medicare and preferred-provider organizations will not mix well, Mathematica Policy Research warns in a recent report.
BusinessWeek October 3, 2005 Howard Gleckman	Medicare: Decisions, Decisions With drug and HMO plans now in the mix, seniors face a raft of complex choices.
Managed Care September 1999 Frank Diamond	Consumers Join The Fray Electoral politics, the Internet, and much more sophisticated patients have all helped to redistribute power among managed care players.
Managed Care January 2001 Richard B. Dwore	Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction...
Managed Care February 2002 Mick L. Diede & Richard Liliedahl	Getting on the Right Track Converging forces are an economic train wreck waiting to happen. Avoiding a disaster requires an understanding of the interconnection of health care's stakeholders and the global consequences of their actions...
Managed Care September 2000	Any way you cut it, employers appear to save if Medicare adopts drug benefit A new analysis suggests that a prescription drug benefit in Medicare would reduce employer expense for health coverage--which, in turn, could encourage more employers to offer some form of drug coverage and thus reverse this erosion...
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.
Managed Care February 2001	Employers more willing to pass benefit costs along Facing significant increases in health-benefit costs, employers appear less willing to bite the bullet than in the past -- and are passing many of those increases on to workers...
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.
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 2003 Martin Sipkoff	This Isn't the First Attempt To Shift Cost to Employees Companies are decreasing their share of medical insurance premiums. It remains to be seen how this will affect workers' health status.
Managed Care April 2006 Patrick Mullen	A Conversation with Paul Fronstin, PhD: Current Crop of Consumer-Directed Plans More 'Lite' Than 'Heavy' Paul Fronstin, a senior research associate at the Employee Benefit Research Institute, speaks about Medicare, health benefit trends, and managed care.
Managed Care April 2001	Employees' tolerance of change underestimated? Health care prognosticators have lately been predicting the coming of a defined-contribution payment system in which an employer would give an employee a voucher (or other stipend) and tell him to go find and purchase his own health care benefits. But employers are unlikely to switch...
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 November 2004 Martin Sipkoff	Death of Community Rating Has Been Greatly Exaggerated The idea that everyone in a given geographical area should pay the same for health coverage has come under assault in recent years.
Managed Care September 2000	Interview: Peter Boland Will the electronic revolution overthrow managed care? Not necessarily, but it may help define a new role for MCOs not far in the future...
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.
CFO June 1, 2005 Russ Banham	Prescription for Malaise? Health-insurance providers are rushing to participate in Medicare's new drug-benefit program. Companies are proceeding with caution.
Knowledge@Wharton July 30, 2003	Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall.
Managed Care December 2006	Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.
Managed Care August 2006	Slowdown in Premium Increase Expected to Continue Into 2007 The only thing falling in terms of health care costs seems to be the rate of increase of premiums - good news for employers and other purchasers.
Managed Care March 2002 Michael D. Dalzell	Defined Contribution: Threat or Fad? Sensing an invasion of their territory, MCOs are jumping into a market forged by a group of upstarts. The development renews a fundamental debate about the juxtaposition of consumer involvement, cost containment, cost shifting, and quality of care...
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.
Knowledge@Wharton	In Battle to Lower Employers' Health Care Costs, Will Employees Become `General Contractors'? Following the backlash against managed care and faced with a sharp rise in health care costs this year, employers are searching for a new cure to spiraling health care premiums...