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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 July 2000	Lee N. Newcomer joins Vivius The former senior VP for health policy at UnitedHealth Group joins a company that aims to shift power from HMOs to patients and physicians.
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 2000 Patrick Mullen	Don't be fooled Don't be fooled, warns noted health care economist J.D. Kleinke: High-quality care costs more, not less. The Internet will increase demand for the best care...
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 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 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 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 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 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 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 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 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 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 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 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 June 2007	A Conversation with Jonathan Weiner, DrPH: Mixing Population-Based Care With Market Controls The United States' health care system needs consumer and market controls to succeed, but it can't rely on only those two factors.
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 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 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 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 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 February 2002	Where HMOs go head to head Almost three quarters (74.2 percent) of the 72.3 million HMO members in metropolitan areas are in large markets...
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 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 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 July 2001 John Otrompke	Stark Allows Federal Regulators To Review Claims Records Fully HMO executives, as well as the providers and physicians who contract with them, should have by now felt the changes in their daily work lives resulting from the government's increased scrutiny of health plans' operations under the fraud-and-abuse compliance laws...
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 September 1999	Physicians Seen As Next in Line For NCQA Review The National Committee for Quality Assurance says it will begin an accreditation program for medical groups two years from now....
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 May 2001 Patrick Mullen	Jeff Goldsmith Deny the increasing importance of the Internet at your peril, says the noted health care futurist. Faster connections, smarter applications are needed...
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 March 2006 Patrick Mullen	Leveling the Field for Docs and Plans: A Conversation with Lucinda (Cindy) Ehnes, JD The director of California's Department of Managed Health Care sees problems if high-deductible plans replace the state's 'delegated model.'
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 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 December 2006	Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.
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 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 April 2002 Jeffrey J. Denning	Does Quality of Care Matter? You Bet! Determine and demonstrate your quality as a physician. Sure, it's unscientific to define quality and then measure it in your own practice. But this isn't the academy, this is business...
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 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 May 2006	They Wrote the Book on Fixing the System How could the largely private U.S. health care system, characterized by arguably more competition than any other health care system in the world, be performing so poorly?
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 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...
Managed Care December 2006	A Conversation With Michael L. Millenson: Health Care Reform Movement Has Only Scratched Surface Michael L. Millenson has long been frustrated by the pace of change says that - ready or not - health care reform is finally on the way.
Managed Care April 2007	A Conversation With Emad Rizk, MD: Disease Management Beyond the Call Center The man who heads McKesson Health Solutions, the third largest disease management program in the country, says it's time to roll out a new model.
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 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 June 2005	Giving More Than a Nod To the Wave of the Future An interview with the director of regional informatics programs through the Vanderbilt Center for Better Health and Accenture professor of biomedical informatics about how his love of medicine and fascination with technology continue to drive his work in the field.
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.