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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 Patrick Mullen	Interview: Peter Lee The head of the Pacific Business Group on Health says the coming trend in care will be patients making informed decisions before they get sick...
Managed Care July 2004	CalPERS Takes Tough Stand In Giving 38 Hospitals the Boot The move is expected to cut spending for the nation's third-largest purchaser of health care by $36 million in 2005, then save CalPERS about $50 million annually beginning in 2006.
Managed Care February 2001	Biz Group Warns Hospitals To Move Quickly on Quality Value-based purchasing, a concept that generates lofty discussion but is not always practiced by employers, took a leap forward with the endorsement of a bloc of some of the nation's largest companies...
The Motley Fool February 26, 2009 Brian Orelli	Big Blue Struts Its Stimulus Stuff The company announces that it had signed up four hospital groups in the U.S. to use its electronic medical records systems, after the stimulus bill contained $19 billion in grants and incentives to encourage doctors and hospitals to invest in electronic medical records.
Managed Care July 2003	Tiering Hospitals Pays Off For Calif. Blues Plan Blue Shield of California members are changing utilization patterns as a result of hospital tiering, say company officials. The company is making further changes in its Network Choice program.
Managed Care May 2002 John Carroll	Hospital Copayments: At What Cost? High daily copayments for high-priced hospitals are coming into fashion. It's all about shifting costs, but what about quality of care?
BusinessWeek July 11, 2005 Timothy J. Mullaney	Cisco: Paging Dr. Info Tech Cisco Systems Inc.'s medical director is backing a plan in which big companies such as Cisco will give doctors financial incentives to adopt technology, with the goal of cutting costs and improving care. This plan is to put Silicon Valley in the vanguard of health-care reform.
Managed Care September 2003	Blue Cross of Calif. Steers Patients Toward Best Hospitals for CABG California seems to be the place where health plans have decided to crack down on hospital costs by spurring better outcomes.
Insurance & Technology August 25, 2004 Marianne Kolbasuk McGee	EMR Initiative: BCBSMA Steals a March One Massachusetts community is going to find out if electronic medical records really can deliver revolutionary improvements in the quality and cost of healthcare.
Managed Care May 2003	Employer Coalition Leaps at Challenge of Grappling With Misaligned Incentives The executive director of the Leapfrog Group says that the organization pleads guilty to trying to create 'aspirational' standards for health care.
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...
BusinessWeek February 7, 2005 Arlene Weintraub	A Remedy For Malpractice Malaise Hospitals are offering free coverage to recruit doctors from private practice
Managed Care June 2002	Calif. Blues Plan Says No Tiers For Hospitals Blue Cross of California has abandoned its plan to separate hospitals by copayment tiers.
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.
Managed Care February 2008	Headlines on Deadline... Blue Cross & Blue Shield wants to stop paying doctors and hospitals for each patient visit or treatment, and instead wants to pay a flat sum per patient each year.
Managed Care December 2007 John Carroll	New York Plan Emerges As Pattern for Rating Physicians The Empire State's approach to physician ratings quickly gains health plan support and consideration as a national answer.
Managed Care June 2001 Jack McCain	Leapfrog Group Actions Will Be Felt Throughout the Health Care System Thanks to a Business Roundtable-sponsored group calling for better outcomes at hospitals, health plans' lobbying efforts may pay off...
Managed Care December 2002 MargaretAnn Cross	Advisory Boards Create Company-Plan Cooperation Very effective if used properly, these panels are not yet widespread. However, that could change as industrial customers demand more input.
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 December 2006 MargaretAnn Cross	Confronting The Medicare Cost Shift Plans are increasingly concerned about the degree to which providers overcharge them to make up for losses from government programs.
BusinessWeek May 29, 2006 Howard Gleckman	Medicine's Industrial Revolution Medical treatments that are proven to work reach only about half of the Americans who need them, according to a series of studies by RAND Corp. And in hospitals, simple measures that protect patients' lives are often hard to implement.
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.
Managed Care March 2004	Hospitals Retain Bargaining Edge In Contract Talks Contract negotiations between health plans and providers, primarily hospitals, were mild in 2002 and 2003, compared to how they played out in 2000 and 2001.
Pharmaceutical Executive April 1, 2007 Humphrey Taylor	Opinion: Inappropriate Behavior Do doctors prescribe needless care? Will healthcare costs drop if patients decide whether treatment is necessary? It's time to start talking.
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 Ed Silverman	Tough Negotiations in Store Between Plans and Hospitals Fallout from the Medicare outlier-payment scandal is likely to force hospitals to try to replace that revenue. Health plans, prepare to negotiate!
Managed Care September 2001 Bob Carlson	Plan-Provider Posturing Draws State Regulators' Ire Network instability is what happens when providers and health plans part company, or threaten to. Lately, many ugly rifts have been the result of contract disputes, invariably conducted in public...
BusinessWeek March 28, 2005	Crusader for Clearer E-Info Entrepreneur Jonathan S. Bush -- yes he's related -- discusses how Web-based medical records can become a workable reality
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 February 2005	Class-Action Suit By 600,000 Docs Heading To Court Discusses a lawsuit filed by about 600,000 physicians against some of the biggest health plans in the country: Humana, PacifiCare, UnitedHealthcare, WellPoint, Anthem, and Health Net. Aetna and Cigna were named but settled out of court.
IndustryWeek January 1, 2008 Adrienne Selko	National Business Group on Honors Best Employers for Healthy Lifestyles The National Business Group on Health, a national non-profit organization recognized on May 9 more than three dozen U.S. employers for their continuing efforts to promote healthy work environments and encourage workers to live healthier lifestyles.
Fast Company April 2006	"MD" Doesn't Mean "Mostly Digital" How technologically backward are U.S. doctors? Here are some statistics.
The Motley Fool April 3, 2008 Brian Orelli	WellPoint Won't Pay The insurance giant refuses to pay for doctors' mistakes.
Managed Care August 2002	Patients' unpaid bills come from physicians, hospitals With health care costs rising and the number of uninsured Americans close to 40 million, physicians and hospitals are feeling the pinch.
Managed Care July 2007 Martin Sipkoff	Hospitals Asked To Account For Errors on Their Watch Centers for Medicare & Medicaid Services and states may stop paying for specific hospital-acquired conditions. Will health plans follow suit?
Managed Care June 2003 John Carroll	Specialty Hospitals' Success Sows Seeds of Lobbying Fight Some in government question the propriety of physicians steering patients into facilities that the doctors partly own.
The Motley Fool May 29, 2009 Brian Orelli	The "Naughty List" You Want Your Company On Athenahealth is out with its annual review of how quickly health insurers are paying the claims that doctors make for services.
Managed Care May 2000	The latest blow to managed care? The Texas attorney general's decision in the Aetna case is the latest in a long string of events that has gutted the fundamentals of managed care. Many in health care think that some or all of these developments have stripped health plans of their ability to manage care effectively....
Job Journal July 25, 2004 Michael Kinsman	Career Pros: Too Few Workers Insured When a problem affects nearly 44 million Americans, it becomes everyone's problem. Industry leaders hope to fund expanded coverage.
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 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.
BusinessWeek November 20, 2008	Financial Triage Innovative ways that hospitals are looking at patient finances.
Nursing Management April 2009 Sharon H. Pappas	Profits, Payers, and Patients: Responding to Changes Profit is necessary for hospitals to fulfill their missions, invest in expansion and new technologies, and reinvest in existing patient care infrastructures. Profitability is the work of the financial team and the clinical team to produce the hospital's desired financial outcome.
Managed Care March 2008 John Carroll	Aetna and Hannaford Make a Singapore Connection Some insurers are taking tentative steps toward developing global provider networks for corporate clients looking to reduce costs by having medical procedures performed in less expensive countries.
Managed Care May 2003 Martin Sipkoff	Working Together on the Medical Side Partly because of employers' demands, health plans are starting to cooperate in ways that improve care.
Managed Care December 2007 Lola Butcher	Insurers Get Involved in Campaign Against Hospital-Acquired Infections Health plans prod hospitals to do a better job of addressing problems that kill nearly 100,000 Americans a year.
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...
CFO May 1, 2009 Josh Hyatt	Strong Medicine Boosted by a substantial injection of cash from the federal stimulus bill, electronic medical records may help relieve the pain of rising premiums by improving efficiencies in the medical system.
National Real Estate Investor December 1, 2004 Matt Hudgins	Pain Relief for Hospitals Hospital systems are anxious to get out of the landlord business as increasing liability insurance costs and reduced Medicare and Medicaid payments put the squeeze on capital budgets.