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Managed Care November 2005 Frank Diamond	Physicians and Plans Can Get Along Hill Physicians Medical Group, one of the largest IPAs in the country, has learned to deliver what managed care plans want
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 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 July 2001 Harry L. Leider	HMOs Need To Share Gains of DM Programs Physicians are more likely to buy in if they see better outcomes -- and financial rewards that go with them...
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 August 2000 Bob Carlson	'All Products' Clauses Fade From Physician Contracts All-products provisions in health plan provider contracts are slowly being negotiated, legislated, and regulated out of existence. They are now illegal in at least four states; legislation is pending in several others.
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 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 June 2007 MargaretAnn Cross	What the Primary Care Physician Shortage Means for Health Plans Insurers fear rising costs and poorer outcomes if members are less able to get appointments with family physicians and general internists.
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 November 2004	Abandonment of Capitation May Inflate MCO's Costs Medical groups and IPAs in strong managed care markets are significantly less likely to use fee-for-service methods to pay their physician members than are organizations in markets with less managed care presence.
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...
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 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 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 October 2000 Maureen Glabman	Giving Some Ground to Physicians Helped Turn Health System Around One hospital system accepted the general wisdom a few years ago by acquiring physician practices. Now it bucks the new wisdom by holding on to them...
Managed Care September 1999 MargaretAnn Cross	It's Too Soon To Write Off Those Suffering PHOs Lessons have been learned from early PHOs, which lacked direction and had misaligned interests between hospitals and physicians.
Managed Care April 2001	Compensation, patient-care time vary widely by practice size Self-employed physicians who practice with one or more other doctors tend to spend more time in patient-care activities than solo practitioners -- and their compensation reflects that...
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 2005	Private Practice Physicians Find Dual Role Challenging When it comes to balancing the role of business owner and practicing physician, many private practice doctors are having a tough time of it.
Managed Care September 1999 Bruce J. Goldstein, J.D. & Mark D. Abruzzo, J.D.	Health Plans That Decredential Docs Must Do It Correctly and Expect a Fight
Managed Care May 2004 MargaretAnn Cross	Will Providers Seek New Contracts As Consumer-Directed Plans Grow? Although plans are not restructuring fee schedules in consumer-directed health plans, providers think their agreements need fine-tuning.
Managed Care February 2001 Debra Gordon	Billing for Alternative Services: Who Gets Paid for What, and How? While health plans have embraced alternative therapies, there's little agreement on how to bill for them. The ability to demonstrate outcomes may help...
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 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 January 2002 Ed Rabinowitz	When Physicians' Skills Fail, Collaboration Beats Punishment New programs hold promise for rehabilitating sound physicians who have, for any number of reasons, lost some of the skills they started with...
Managed Care January 2007	Change From Salary to Relative Value Units Leads to Higher Income for Physicians A Minnesota medical group that contracted with HealthPartners was able to improve cost of care, physician compensation, and patient access without harming patient satisfaction when the group converted from a salary payment system for physicians to one solely dependent on physician productivity.
Managed Care April 2000 Tim Olsen	Physician, Tarnish Not Thine Image Doctors who use the news media to criticize others, rather than initiate a constructive dialog about difficult issues such as antibiotic resistance, help erode the profession's influence.
Fast Company April 2006	"MD" Doesn't Mean "Mostly Digital" How technologically backward are U.S. doctors? Here are some statistics.
Managed Care January 2005 Alice G. Gosfield	P4P: Transitional at Best Pay-for-performance (P4P) programs promise a fair shake for provider and insurance plan, but a former chairman of the National Committee for Quality Assurance sees many design flaws to overcome.
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 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 December 2006	Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.
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 March 2000	Tracking the Tracker of Health Care's Trends The president of the Medical Group Management Association encourages changes that would bring physician practice and medical record-keeping in step with the times, and decries the lack of medical standards across plans.
Managed Care July 2004	Hill Physicians Medical Group Outshines California's Pay-for-Performance Program Hill paid out twice the amount as the state plan because the medical group program is older and more mature.
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...
Pharmaceutical Executive January 1, 2013 Al Topin	The Doctor-Patient Disconnect Doctor-patient conversations aren't always what we think; this basic interaction represents both a problem and an opportunity for today's drug marketers, says the author.
Financial Planning August 1, 2008 David A. Twibell	House Calls Working with physicians can be rewarding, but to be successful, advisors need to develop the skills to tackle the unique problems facing doctors.
Managed Care January 2006	Compensation Monitor A recent poll reveals that doctors distrust pay for performance programs.
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 July 2001 Maureen Glabman	Provider Shortage Puts HMOs In Bind Increasing demand for physicians and physician extenders is starting to strain the system. To a large extent, this is unexpected bitter fruit of managed care's labor...
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 2000	Internet revolution not yet impressing most physicians For all the potential of the Internet to erase old physician doubts about integrating information technology into everyday practice, scant few doctors have embraced it.
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 March 2005 William F. Jessee	What Do Physicians Want From Health Plans? Standardizing health plan administrative processes and eliminating duplication of effort would go a long way toward strengthening the doctor-insurer relationship.
Pharmaceutical Executive October 1, 2011	Arming up for the Digital Revolution As a longtime advocate of new approaches to meeting customer needs in pharma, Martin Wygod sees the biggest change as the coming growth of digital platforms as the principal source of information and communication in healthcare.
Managed Care July 2002	Money isn't everything Physicians are fairly happy with their incomes, but unhappy with the number of hours they have to work, as well as with the ancillary duties involved in practicing medicine, according to a survey.
Managed Care May 2006 Michael Levin-Epstein	Looking for a Better Way To Manage Care Can primary care physicians persuade health plans and Medicare to accept their version of the chronic care model?