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Managed Care
November 2000 |
For first time ever, HMO enrollment drops in 1999 National HMO enrollment fell by 400,000 last year, from its all-time high of 81.3 million. For at least two years, a wider array of managed care products and an ever-smaller pool of people still covered under indemnity plans slowed the rate of HMO enrollment growth...   |
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... |
Managed Care
January 2001 |
More HMOs to fold, consolidate in 2001 More than six dozen HMOs have characteristics that put them in danger of going out of business, according to projections by InterStudy publications... |
Managed Care
April 2000 |
Fallout from the "new economy": claims payment slower than ever A new InterStudy Publications report says HMOs relied heavily on investor funds during the 1990s to cover medical and operational expenses, and premiums alone were not enough. The resulting cash crunch means health plans are taking longer than ever to pay claims... |
Managed Care
February 2001 |
2001 Could Be Good Year For Managed Care Industry Median earnings for managed care organizations are expected to grow 17 percent this year, according to a forecast by Merrill Lynch. The report suggests that while enrollment increases will remain tepid, well-positioned companies will benefit from increased market share... |
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
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
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
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
January 2001
Richard B. Dwore |
Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction... |
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
December 2002 |
California Puts Doctor Scores On Report Cards The competency of physician groups is often as important as HMO performance in determining patient outcomes, California health regulators have decided |
Managed Care
March 2000
Mark D. Abruzzo |
Beating Obesity Begins By Expanding Tort Reform It's been suggested that, in order to battle obesity, HMOs should use their collective information and knowledge to change their members' behavior.... |
Managed Care
March 2001 |
Premiums outstrip medical costs for first time in 6 years Whether this pricing tactic helps health plans return to profitability remains to be seen, but it appears the industry's financial picture is brightening... |
Managed Care
July 2000 |
Bed days higher in smaller markets? Not with commercial plans When it comes to hospitalization, patients in cities have long spent less time in hospital beds than those in smaller markets. New data suggest this is still true for Medicare and Medicaid members -- but where commercial plans are concerned, the mean days-per-thousand figure was lowest in small markets. |
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
September 1999
Frank Diamond Senior Editor |
Florida Medicaid Moves Toward Direct Contracting Florida will soon test a program that could provide competition for HMOs serving the Medicaid population. Other states are watching. |
OCC Bulletin
April 20, 2005 |
Community Reinvestment Act This U.S. Census and 2005 Department of Housing and Urban Development data includes estimated median family incomes for metropolitan statistical areas, metropolitan divisions, and nonmetropolitan portions of each state. |
Managed Care
March 2006 |
Will HMOs' Robust Profits Make Good Political Fodder? Those looking for any excuse to bash HMOs, including political gain, will turn anything into a weapon, including a recent study pointing to healthy profits. |
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 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 1999
Richard Hamer |
Goals 2000: For HMOs: Administrative Retooling For MDs: Managerial Competency ...While HMOs retrench, physicians need to become more constructive participants.... |
OCC Bulletin
September 9, 2004 |
Community Reinvestment Act The U.S. Census data, which are based on 2000 income data, were recently updated to reflect revisions made by the Office of Management and Budget to the definitions and boundaries of MSAs and MDs. |
Managed Care
March 2002
Charles Downey |
The Department of Managed Care California sets a precedent again, with a bold effort to regulate the HMO industry. While the new Department of Managed Health Care is facing down 50,000 consumer gripes monthly, director Daniel Zingale intends to keep administrative red tape from overwhelming everyone... |
Managed Care
June 2002
Jeffry R. Ellis |
Third-Party Payers Don't Realize Burdens Placed on Pharmacists PBMs and HMOs, by imposing a workload that doesn't allow enough time for needed functions, seem to want pharmacists to fail, this author asserts. |
