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Managed Care January 2002 Donald Wilcox & Stephanie Kanwit	Debating RICO Suits vs. Health Plans States Failed To Protect Docs From Insurers... Patients Will Suffer; Greedy Lawyers to Blame...
Managed Care April 2001	Court Ruling May Mean Resolution Or Revolution A key federal court ruling was expected at press time on a series of lawsuits against the HMO industry. Additionally, the nation's largest managed care operator reportedly is negotiating a settlement...
BusinessWeek March 31, 2011 Peter Waldman	Aetna's Rx for High Doctor Fees: Lawsuits Aetna's legal campaign against expensive out-of-network charges is just the latest attempt by insurers to restrain soaring health costs.
ifeminists June 30, 2004 Wendy McElroy	Jackpot Justice, the Wal-Mart Case No one knows how to definitively resolve the abuses and dangers of class action suits without denying the underdog access to the courts.
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.
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.
Managed Care November 2005	Headlines On Deadline ... Health insurance costs only increase by 9.2 percent this year....Humana agrees to pay $40 million in settlement... Department of Health and Human Services fails to report several medical malpractice claims...
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 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 August 2004 Michael S. Victoroff	We Don't Serve Your Kind! When physicians think it is acceptable to withhold care from lawyers involved in malpractice suits, does it signal a breakdown of the social order?
Managed Care July 2003 Ed Silverman	A Little Something For the Physicians Health plans know that getting along with physicians is important, and many are trying new initiatives. Here are some successes.
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...
AskMen.com Tara Weiss	Reasons Not To Become A Doctor There were once many rewards to being in the medical profession. For decades, doctors earned hefty paychecks, had autonomy and respect. Those benefits are fading, and as a result, so is the number of doctors.
The Motley Fool January 28, 2008 Dan Caplinger	Travel Abroad? Get Back Some Money It's time for credit card companies to pay you back. The result of a recent suit was a settlement that could get you some money back if you've paid currency-conversion fees while traveling in a foreign country between 1996 and 2006.
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 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 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 August 2001 John Carroll	Info on Questionable Physicians Languishes in National Data Bank A clearinghouse was created that stores details about malpractice suits and disciplinary actions. So how come HMOs don't use it?
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.
Insurance & Technology October 29, 2003 Anthony O'Donnell	Aetna Offers Solution to Suit The carrier's settlement with the American Dental Association aims at communications clarity.
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 December 2002 Diane Cook	Beware the Hidden Consequences of the Malpractice Crisis Soaring malpractice insurance rates are thinning out provider ranks in at least a dozen states. Could access problems pose issues for HMOs in those areas?
Reason August 2002 Michael McMenamin	Knave of Torts Cooler coffee for $3 million and other lawyer bargains: a review of Why Lawsuits Are Good for America: Disciplined Democracy, Big Business, and the Common Law, by Carl T. Bogus
Managed Care September 2000 Frank Diamond	'New' Aetna and Kaiser Face Future The biggest for-profit and not-for-profit MCOs have been through rough times recently. How have their corporate cultures changed?
The Motley Fool August 28, 2009 Brian Orelli	Your Doctor Is Killing You ... Financially What the doctor does has a big effect on how much health care costs.
Financial Planning April 1, 2010 Rick Kahler	Healthcare on the Critical List Even if Congress does enact a new law, it seems that the same old problems will remain, at least for the next few years. So let's take a careful look at what's at stake.
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.
Entrepreneur February 2005 Jane Easter Bahls	It's Settled A new law makes it easier to reach settlements in employment discrimination cases.
The Motley Fool September 24, 2008 Brian Orelli	Health Insurer Lets Outsiders Decide Aetna announces that it'll allow customers with individual health plans to ask for an independent external review before Aetna cancels their policy.
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 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 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...
The Motley Fool October 3, 2007 Rich Smith	Aetna's $1.25 Billion Buyback The health insurer Aetna splurges on its own shares; its board has authorized a $1.25 billion hike in its stock-repurchase authorization.
BusinessWeek November 7, 2005 Lorraine Woellert	A Break For The Defense As doctors who validate tort claims come under scrutiny, business is on the offensive.
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 October 2007 John Carroll	Early Tiered Networks Encounter Many Obstacles From dodgy data to uncooperative doctors, difficulties confront health plans that are trying to stratify providers by cost and quality.
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 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 March 2004 Martin Sipkoff	Can Transparency Save Health Care? If everyone can see what everyone is doing, we'll have better care at lower costs. First task: Create common standards.
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 May 2000 Frank Diamond Senior Editor	Medical Director: A Typical Day Requires Both Strength and Tact Ruling on queries from phone banks, working to end hospital errors, meeting with disgruntled physicians: Does any of this sound familiar?
BusinessWeek January 16, 2006 Jessi Hempel	Aetna: Succession At Full Speed Can incoming Aetna CEO Ron Williams keep the health insurer on its hot streak?
Insurance & Technology September 16, 2005 Katherine Burger	Educating Consumers A truly technology-enabled offering, the idea behind consumer-directed healthcare is that everyone benefits when consumers have more information.
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.
BusinessWeek January 8, 2007 Michael Orey	How Business Trounced The Trial Lawyers By focusing on litigation reform at the state level, business has won key battles. Suddenly, it's a tough time to be a plantiffs' attorney.
Financial Advisor May 2006 Bruce W. Fraser	An Undiscovered Asset Class Most advisors know little about the structured settlements market, yet the dollar amounts in settlements can range into the millions of dollars, thus making them a potentially profitable niche market for wealth managers and other fee-only advisors.
Managed Care December 2007 Tom Reinke	U.S. Health Insurers Find Opportunities Overseas The United Kingdom is proving hospitable to UnitedHealth Group and Aetna, and there is business to be had elsewhere in Europe and on other continents
Managed Care December 2002 Michael S. Victoroff	Cashing In on Obesity? Obesity is a tricky problem for managed care companies. The "American disease" is so mediaphilic that it routinely generates nutty suggestions. It was only a matter of time until someone found somebody to sue.