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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...
Salon.com October 14, 1999 Dawn MacKeen	Woe is HMO Proponents of liability legislation argue that the only way to change managed care's behavior is to threaten it with lawsuits.
Managed Care April 2000 Mark Abernathy	Avoid Common Problems In Risk-Sharing Contracts These arrangements too often become a hindrance instead of a help. Simple precautions today can help prevent major headaches later on.
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 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 2007 Maureen Glabman	Will 'Mea Culpa' Work for Health Plans Too? Hospitals and physicians, to varying degrees, are finding that doing the right thing is good business practice.
Managed Care January 2002 Donald Wilcox & Stephanie Kanwit	Debating RICO Suits vs. Health Plans States Failed To Protect Docs From Insurers... Patients Will Suffer; Greedy Lawyers to Blame...
Managed Care October 2000 Patrick Mullen	Interview: Steven B. Epstein, J.D. This pioneering medical legal authority says health plans and physicians should stop fighting over scraps the government throws them...
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 January 2001 Richard B. Dwore	Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction...
Managed Care November 1999 John La Puma, M.D.	Expanding HMO Liability: Ethical, But Not the Point ...Many states are not waiting for the federal debate about expanding HMO liability to play out...
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 April 2007 Frank Diamond	What If? Health care economists and others imagine a society in which managed care had never been invented.
Reason November 2004 Ronald Bailey	Mandatory Health Insurance Now! It will save private medicine in the U.S. -- and spur medical innovation.
Managed Care May 2001	Study: Consumers benefited most during '90s conversion to managed care Out-of-pocket spending on health care went virtually unchanged from 1990 to 1997, thanks in large part to employers' conversion from indemnity plans to managed care...
Managed Care August 2002 Maureen Glabman	Lobbyists That the Founders Just Never Dreamed of The "right ... to petition the government" has come a long way in over 200 years, and health care organizations are not shy in exercising it.
Managed Care September 2001 Michael D. Dalzell	Where Will Health Plans Find The Next Generation of Savings? The industry realizes that it needs to get creative -- or perish, at least in the form it has taken. Employers won't stand long for double-digit premium hikes. With much of the fat already wrung out of care delivery, where will health plans find that next generation of cost savings?
Managed Care July 2000 John Carroll	Physicians Reconsider Taking On Pharmacy Risk They've been burned here in the past, but physicians - and the HMOs that they contract with - may have learned some lessons.
Managed Care December 2000 Patrick Mullen	Employer Demands Will Change Healthcare The CEO of a large Florida employer coalition insists that the information that companies are beginning to demand will force the industry to change...
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 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...
Pharmaceutical Executive June 1, 2014 Ben Comer	Take as Directed: From Force to Finesse in Promoting Adherence Healthcare players tout patient education and engagement as the keys to better drug adherence rates. Patients agree, as long as that translates to convenient and affordable access to therapy.
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 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.
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.
BusinessWeek November 12, 2009 Catherine Arnst	10 Ways to Cut Health-Care Costs Right Now Employers and hospitals don't have to wait for Congress to address inefficiencies and waste.
Managed Care April 2002	Ruling Makes Class-Action Suit More Plausible The idea of a class-action lawsuit against HMOs was boosted by a recent decision in a federal court in Florida. Meanwhile, the Blue Cross and Blue Shield Association has sounded the alarm that efforts to increase health plan liability may be launched in at least eight states...
Managed Care December 2000 Maureen Glabman	Downstream Without a Paddle State legislatures that tackle medical group insolvencies have come up with strategies that sometimes shift accountability to HMOs...
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.
Managed Care September 2003 MargaretAnn Cross	Consumer-Directed Health Care: Too Good To Be True? People talk about it as the sure way to control costs and give consumers the choice they seem to want. Are we being realistic?
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 August 2002 Frank Diamond	Moving Consumers to the Head of the Class Creating a customer base that's aware of the link between cost and services has become the next big challenge in managed care. It's a daunting task.
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 May 2001 Jack McCain	Use of Hospitalists: Another Case of 'May' vs. 'Must' Despite a movement to ban mandatory use of these physicians, their numbers and influence are rising as their roles become better understood...
Managed Care July 2002 Michael D. Dalzell	Has Capitation Weathered the Storm? More difficult than ever to pull off, health care on a fixed, per-capita budget has gone out of style in a number of areas. But many things are cyclical - and this trend may be, too.
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 April 2007 Daniel Y. Patterson	HMO - 21st Century Model The history of HMOs has been one of conflict between plans and physicians. Could global specialty capitation be a better way?
Managed Care January 2006 Maureen Glabman	What Doctors Don't Know About the New Plan Designs Physicians are fairly ignorant of what consumer-directed health care will mean to them in terms of relations with patients and health plans.
Managed Care March 2004 John Carroll	Narrow Networks' Broader Vision Throughout the late 1990s, the fashion in managed care networks was bigger and bigger. These days, though, health plans around the country have begun sizing up so-called narrow networks once again.
Pharmaceutical Executive March 1, 2014 William Looney	The Call to Community: A Conversation with Dr. David Nash Population health is the foundation for much of what is truly new in US health reform. For big Pharma, it represents yet another escalation in expectations.
Managed Care August 2001	Four Views of Managed Care Ethics The evolution of managed care has posed ethical problems for physicians, plan administrators, and even patients. Four ethicists find that questions are many, while satisfactory answers are in short supply...
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.
Managed Care November 1999 Uwe Reinhardt, Ph.D.	Defined Contributions Will Point Employees Toward 'Health Marts' Companies will want to distance themselves from insurance entanglements, giving employees little option but to become more involved....
Managed Care July 2000 Neville M. Bilimoria, J.D.	HMOs Continue Losing Ground On Liability Issues at State Level The recent U.S. Supreme Court decision offers a nice breather, but executives should not let down their guard, as an Illinois ruling shows.
Managed Care July 2001 Michael Levin-Epstein	Tilt of Senate to Democrats Speeded Debate on Patients' Rights The Senate debate over the Patients' Bill of Rights made for great theater, but was the outcome ever in doubt?
Managed Care August 2000 Mark D. Abruzzo, J.D.	Supreme Court Ruling Encourages Greater Awareness Among Patients To you and me, the court's holding in Pegram means that patients cannot sue HMOs under ERISA for giving doctors financial incentives to hold down costs. However, as is typical with many court decisions, this makes one wonder whether it doesn't take on a much greater meaning.
Salon.com July 17, 2001 Jake Tapper	The healthcare disaster that wasn't When Texas passed its patients' bill of rights law, George W. Bush warned that it would unleash a plague of lawyers and drive up health costs. It didn't...
BusinessWeek June 25, 2009 Catherine Arnst	The Family Doctor: A Remedy for Health-Care Costs? How making primary-care physicians the center of America's health-care system could drive down costs.
Managed Care November 2003 Martin Sipkoff	9 Ways To Reduce Unwarranted Variation Unwarranted variation in medical practice is costly -- and deadly. When the approach in one town is major surgery and in another, it's watchful waiting, you know there's a problem.
Managed Care September 2001 Jack McCain	Minnesota Buyers Coalition Back On Feet, Plans Expansion An employer group called Minnesota's Buyers Health Care Action Group (BHCAG) tries to contract directly with local groups of health care providers. After setbacks, they're still at it...