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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 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 1999 Allen Briskin & Gerry Hinkley	HMO Liability Battleground Moving to Courts, Statehouse The adage "all politics is local" may, in the end, become the motto that sinks ERISA. HMO executives should assume protection will evaporate.
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 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 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 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 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 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 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 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 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 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 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 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 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.
Pharmaceutical Executive September 1, 2012 Al Topin	Doctors' Words No Longer Gospel In the digital age, physicians don't call the shots when it comes to healthcare guidance. Marketers must appeal to multiple sources in seeking ways to garner patient adherence and loyalty.
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 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 November 2005 MargaretAnn Cross	Health Plans by Design, Not by Default Fortune 500 employers are ready to shed old benefit models for "managed consumerism".
Pharmaceutical Executive October 1, 2006	Sales and Marketing: Where the Buck Stops Pharma's ultimate customer is the employer - the guy who pays the health plan's bill. Here's what he wants to know about drugs.
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 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 January 2002 Frank Diamond	Making the Case for a 'Health Care Fed' A U.S. government agency, some argue, should be created to rule on usefulness of medications, equipment, and procedures. Britain has just instituted such a system...
HBS Working Knowledge July 16, 2008 Porter et al.	What Should Employers do About Health Care? Companies that cut health care costs without improving the overall value of care eventually pay a price in terms of employee absenteeism and chronic ailments.
Managed Care August 2006	Headlines On Deadline ... Aetna is unveiling something it calls the Medicare Open Plan, targeted for employers who want to offer retirees age 65 or over a fee-for-service Medicare Advantage plan.
HBS Working Knowledge July 13, 2009	Diagnosing the Public Health Care Alternative With deep experience in health insurance reform, HBS faculty describe how improved competition in insurance plans could improve value for patients.
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 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 July 2000	HMO Incentives Not Grounds for Suit U.S. Supreme Court Rules Unanimously Use of financial incentives in HMOs' contracts with physicians may be losing favor, but it's not about to be declared outright illegal any time soon. The U.S. Supreme Court ruled unanimously that patients maynot sue a health plan just because it offers physicians incentives intended to limit health care services.
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 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 2001	Employees' tolerance of change underestimated? Health care prognosticators have lately been predicting the coming of a defined-contribution payment system in which an employer would give an employee a voucher (or other stipend) and tell him to go find and purchase his own health care benefits. But employers are unlikely to switch...
Managed Care March 2002 Charles Downey	The Department of Managed Care California sets a precedent again, with a bold effort to regulate the HMO industry. While the new Department of Managed Health Care is facing down 50,000 consumer gripes monthly, director Daniel Zingale intends to keep administrative red tape from overwhelming everyone...
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.
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 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.