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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 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....
Managed Care June 2004 John Carroll	This Regulator Works For the Governator California is the only state that has a department that deals exclusively with HMOs. A new sheriff's in town.
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.
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 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 January 2001 Richard B. Dwore	Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction...
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 April 2000	Financial Stability Of HMOs Called A Mixed Bag An HCIA-Sachs survey says the median HMO profit margin in 1998 was -1.7 percent, slightly better than in 1997. Forty-one percent of HMOs made money in 1998....
Managed Care June 2002 Frank Diamond	A Look at Kaiser CEO's Legacy: Faith in Quality Never Waned David M. Lawrence, MD, MPH, guided the country's largest not-for-profit health plan through the tumultuous managed care decade.
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...
Managed Care July 2002 John A. Marcille	Capitation as Whipping Boy: Court Takes on Touchy Issue If plans are to keep coverage decisions reasonable and fair, they'll need tools that involve physicians and patients in the decision-making process. Capitation is one of those.
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.
Managed Care November 1999	U.S. Supreme Court To Hear Suit Against HMOs Over Incentives Can HMOs be sued for the practice of offering bonuses to physicians who help them keep the cost of care down?...
Managed Care October 2003 MargaretAnn Cross	Some HMOs See Dividends In Charging Deductibles This may be one way to regain profitability, though getting permission from government regulators may take some doing.
Managed Care June 2002 Bob Carlson	First Business, Now Health Care: Signing Away One's Right To Sue More and more, mandatory arbitration clauses are surfacing in agreements between businesses and individuals. Will the line be drawn at managed care?
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.
Salon.com June 13, 2000 David McGuire	Immune from liability The Supreme Court blocks a potentially important legal path for people who want to sue HMOs. Now, the spotlight is on Congress.
Managed Care September 1999 Bob Carlson	Businesses Brace for Premium Hikes as Reform Fever Strikes California California will soon enact its first batch of health care laws in over a decade....
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 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 MargaretAnn Cross	Momentum Shifts Toward Consumer-Directed Plans Looking at past enrollment shifts and at the evolution of managed care can shed light on how to compete in the new market for account-based consumer-directed care.
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 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 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...
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 October 2004	Kaiser Seen as Biggest Earner as HMO Profits Soared in 2003 The good times rolled on for the nation's HMOs in 2003. The industry nearly doubled its profits, earning $10.2 billion, an 86 percent increase from the $5.5 billion it earned in 2002.
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 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 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 2001 Frank Diamond	Consumers Dare You to Just Say 'No' The backlash has helped push a Patients' Bill of Rights forward, challenging the very nature of cost containment. Ironically, enrollees may be shortchanged...
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 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.
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 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 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 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...
Managed Care July 2000	Are Gatekeepers Failing To Control Specialty Costs? The importance of a gatekeeper in keeping costs down has been challenged again -- this time in a study that compares physician utilization for HMOs and point-of-service plans.
Salon.com July 4, 2001 Alicia Montgomery	Could just anyone get a pacemaker like Cheney's? Not necessarily, HMO critics say. And Bush has already promised to veto a bill that would help patients get care as good as the vice president's...
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 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.
Salon.com August 23, 2000 Jake Tapper	Patient politics Will healthcare be the albatross around George W. Bush's neck? Al Gore thinks so.
Managed Care August 2000 Michael Levin-Epstein	Will Fifth Circuit's Decision Spur Action on Patient Rights? The recent Fifth Circuit Court decision on Texas's statute allowing patients to sue HMOs for denial of physician-recommended care is helping to clarify where state and federal interests in patient rights lie -- and what Congress could do to spell out those interests.
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 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 2001 Michael Levin-Epstein	PPO Performance Hard To Gauge; Comparisons to HMOs Not Reliable It's long been said that PPOs, by their varied nature, can't be held to the same quality yardsticks as HMOs. Yet, in time, something will have to suffice...
Managed Care October 2000	Large HMOs Do Well While Small Ones Slide Weiss Ratings reports that the nation's HMOs lost a collective $187 million during 1999, despite the positive performance of most of the country's largest managed care organizations...
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 January 2007	Headlines on Deadline ... State budgets got an unexpected gift last year... Mortality rates for hospitals ranked high... It looks likely that Massachusetts Gov. Mitt Romney will run for president... etc.
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.