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Managed Care
August 2000
Medicare+Choice pullouts' deep, deep sting The health plan exodus from Medicare+Choice will affect 934,000 people in 2001 -- more than were affected in 1999 and 2000 combined, according to the Health Care Financing Administration. mark for My Articles similar articles
Managed Care
February 2001
In Medicare Bill, HMOs Got What They Wanted When the dust cleared over how $35 billion in Medicare "givebacks" would be divided, the Republicans prevailed -- Medicare HMOs got a bigger cut than Democrats wanted to give them. Now, President Bush may be poised to give Medicare managed care plans more... mark for My Articles similar articles
Managed Care
September 2000
Headlines on Deadline Chest X-rays do not save lives when used to screen for lung cancer, according to a 20-year study... physician are leaving California in droves... Congress will consider restoring $21 billion in Balanced Budget Act cuts to Medicare providers over five years... etc. mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
December 2002
Providers turn to fee-for-service charges to make up revenue lost under capitation If there's any doubt whether capitation has left a bit of a sour taste in the mouths of physicians and hospitals, a survey issued earlier this year would seem to confirm it. mark for My Articles similar articles
Managed Care
November 2001
Medicare+Choice Problems Chasing Away 58 Health Plans Medicare+Choice, the program that was supposed to ease the elderly into managed care, is itself suffering from the uneasiness of HMOs dissatisfied with payment rates... mark for My Articles similar articles
Knowledge@Wharton Prescription Drug Coverage for Seniors Faces Uncertain Future The discussion about adding a prescription drug benefit to Medicare will be put on hold... mark for My Articles similar articles
Managed Care
July 2007
AMA: Patients Will Feel Cuts in Medicare Next year's proposed 10 percent cut in Medicare payments is serving as a rallying point for members of the American Medical Association, which says the cuts will make it difficult for physicians to accept new Medicare patients. mark for My Articles similar articles
Managed Care
February 2004
John A. Marcille
The Administration Delivers A Major Gift to Managed Care Which brings me to the announcement that Medicare payments to health plans participating in what was called Medicare+Choice but is now known as MedicareAdvantage will increase by a record 10.6 percent. mark for My Articles similar articles
Financial Planning
July 1, 2006
Robert M. Hayes
Preserve Medicare Medicare is a roadmap for the future healthcare of America. It should be fine-tuned and improved, not undermined and privatized as the Washington power brokers are now attempting to do. mark for My Articles similar articles
Managed Care
May 2000
Michael Levin-Epstein
Marketing Medicare+Choice? Mind Your Ps and Qs, Says OIG A lot of Medicare HMOs' marketing materials don't cut it, says a report by the Office of the Inspector General. It adds that the Health Care Financing Administration is partly to blame.... mark for My Articles similar articles
Managed Care
November 1999
Medicare Reform Dead for Now On Capitol Hill mark for My Articles similar articles
The Motley Fool
January 22, 2007
Dan Caplinger
Understanding Medicare: Claims In general, Medicare provides a level of coverage that is fairly similar to what private health insurance plans offer. Here are some tips for getting the most from it. mark for My Articles similar articles
Managed Care
October 2000
Quick Fix May Be in Store for M+C, But Meaningful Change Likely To Wait Whatever diversion prescription drug proposals have provided, Medicare+Choice is back on Congress's radar screen. While sentiment is again running strong among legislators to address the wounded program, Congress is now racing a clock ticking ever closer to the elections... mark for My Articles similar articles
Financial Planning
November 1, 2007
Donald Jay Korn
Medicare Choices What are Medicare private fee-for-service plans and why did their fortunes rise and fall so dramatically? Most important, if these plans survive in their current form, should advisors suggest them for clients enrolled in or approaching Medicare eligibility? mark for My Articles similar articles
Managed Care
March 2001
Bush: Medicare Drug Benefit Tied To Overall Reform Working quickly, President Bush has drafted the first half of his prescription drug plan for Medicare and sent it to Congress... mark for My Articles similar articles
The Motley Fool
March 4, 2004
Philip Durell
Lincare Fighting for Air Lincare Holdings (Nasdaq: LNCR) knew it was coming and so did investors, but the severity of the new Medicare Bill has left them breathless! The November 2003 passing of the bill contained provisions that, if implemented, would severely cut revenues and net profit margins. mark for My Articles similar articles
Managed Care
May 2002
Primary Care Suffers Under M+C, Study Says Medicare+Choice compares unfavorably with traditional fee-for-service Medicare in 9 out of 11 features linked to primary care, according to a study funded by the U.S. Agency for Healthcare Research and Quality that is generating interest and controversy mark for My Articles similar articles
Managed Care
April 2000
Cigna Colorado Ends Capitation For Most Primary Care Physicians In a strategic move aimed at retaining and recruiting top physicians, Cigna HealthCare of Colorado has dumped capitation. In late February, the insurer began paying most of its physicians in the state on a discounted fee-for-service basis.... mark for My Articles similar articles
Managed Care
March 2002
How Medicare beneficiaries spend money on drugs The Kaiser Family Foundation notes that Medicare beneficiaries account for 14 percent of the U.S. population, but for 43 percent of the nation's spending on prescription drugs. Thirteen percent of beneficiaries had to pay $2,000 or more out of pocket in 2001... mark for My Articles similar articles
Managed Care
April 2002
John A. Marcille
Nobody Wants M+C To Die, So Why Can't We Make It Work? Money alone can't solve all of Medicare+Choice's woes, and structural problems will need to be addressed... mark for My Articles similar articles
Managed Care
September 2003
Medicare+Choice expenses increasing for enrollees Those who argue that Medicare and managed care don't mix well have new data to take to the fight. A Commonwealth Fund report states that the average out-of-pocket costs for Medicare+Choice enrollees soared 10 percent this year. mark for My Articles similar articles
Managed Care
May 2001
Jeffrey J. Denning
How To Challenge Medicare Payments Less than 6 percent of Medicare payments are protested. Of those, about 6 in 10 result in increased compensation for the physician. Odds are on your side... mark for My Articles similar articles
Managed Care
July 2002
Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1. mark for My Articles similar articles
On Wall Street
November 1, 2012
Todd Colbeck
Boost Your Medicare Expertise What every advisor should know about government insurance to better serve clients. mark for My Articles similar articles
Managed Care
July 2004
Headlines On Deadline ... In a major victory for HMOs, the Supreme Court voted unanimously on June 21 that patients may not sue health plans in state courts for refusing to pay for medical care recommended by physicians. mark for My Articles similar articles
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... mark for My Articles similar articles
Managed Care
September 2002
Medicare holds down physician pay Compensation increased at a comparatively small rate from 2000 to 2001 for both primary care physicians and specialists, according to the Medical Group Management Association. mark for My Articles similar articles
Managed Care
March 2002
NCQA To Help CMS Monitor Quality of M+C Plans The National Committee for Quality Assurance has been tapped to help the Centers for Medicare and Medicaid Services (formerly HCFA) monitor plans that participate in Medicare+Choice... mark for My Articles similar articles
Managed Care
February 2006
Medicare's Efficiency Over-Hyped, Study Claims The belief that Medicare is a more efficient system than employee-sponsored health insurance comes under fire in a study that claims there are hidden costs in the government program. mark for My Articles similar articles
Pharmaceutical Executive
May 1, 2005
Erik Felker
Elephant or Specialist? The Bush Administration has put in place the groundwork for new market forces that will forever change how pharmaceuticals are commercialized. Although the long-term impact of this change is not known, unprepared companies are at a serious disadvantage. mark for My Articles similar articles
Managed Care
May 2007
John Marcille
Pay for Performance Proceeds at Proper Pace The incrementalist pay-for-performance will be with us long after Medicare private fee-for-service plan is history. mark for My Articles similar articles
Managed Care
April 2005
Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation. mark for My Articles similar articles
Managed Care
March 2002
Michael Levin-Epstein
Illinois's Medicare Drug Program Called 1st Stab at National Reform The Illinois demonstration program gives the state permission to use federal and state Medicaid dollars to provide prescription drug coverage for 365,000 low-income, elderly Medicare beneficiaries... mark for My Articles similar articles
Financial Planning
April 1, 2007
Joan Warner
What's Next for Medicare Is America's retirement healthcare plan really in trouble? Here's some good news -- and some hard decisions for your financial advisory clients. mark for My Articles similar articles
Managed Care
June 2002
John Carroll
DM and Medicare: A Marriage Made in Heaven? With a budget of about $230 billion for 40 million patients, many with chronic ailments, is it any wonder that disease management and Medicare are courting? mark for My Articles similar articles
Managed Care
April 2005
Frank Diamond
Starting Medicare Advantage Plan Brings Special Set of Problems The feds will help you launch a health plan for the elderly, but just what does it take to get something like this operating in so short a time? mark for My Articles similar articles
The Motley Fool
August 1, 2005
Stephen D. Simpson
Humana Hums a Merry Tune Humana's Medicare business stays strong. While these shares have already enjoyed a great run (up more than 120% in the past year), today's guidance would suggest Humana still has room to grow and improve. mark for My Articles similar articles
The Motley Fool
December 11, 2007
Brian Orelli
Medicare Whacks Oncology Drugs Bad news for some pharmaceutical companies as Medicare announces it is reducing the reimbursement rate for two lymphoma drugs. mark for My Articles similar articles
Managed Care
November 2003
Study Says PPOs Don't Mix Well With Medicare Despite the will and wishes of many members of Congress, Medicare and preferred-provider organizations will not mix well, Mathematica Policy Research warns in a recent report. mark for My Articles similar articles
Financial Planning
April 1, 2010
Donald Jay Korn
Medicare: Change is Coming This is a great time to get together with clients over 65 who will be affected by health care changes and go over their Medicare coverage. At the same time, you can see what other areas of financial planning are on their mind. mark for My Articles similar articles
Knowledge@Wharton
July 30, 2003
Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall. mark for My Articles similar articles
Financial Planning
February 1, 2006
Marie F. Smith
AARP's Blueprint Americans can -- and should -- pull together to create a secure future for its citizens. To suggest that an older America will precipitate a crisis overstates the problem and fails to consider some major mitigating factors. mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
August 2001
GAO: Consultants Point Docs Toward Federal Law Violations The General Accounting Office has found that some health care consultants have been advising physicians to do things that conflict with federal laws and that may be unethical... mark for My Articles similar articles
The Motley Fool
July 1, 2011
Luke Timmerman
Dendreon Sways Medicare to Pay for Prostate Cancer Drug The decision by Medicare is no surprise, but it does conclude a period of uncertainty about insurance reimbursement for its lone marketed product. mark for My Articles similar articles
BusinessWeek
October 3, 2005
Howard Gleckman
Medicare: Decisions, Decisions With drug and HMO plans now in the mix, seniors face a raft of complex choices. mark for My Articles similar articles
Managed Care
December 2003
John A. Marcille
Will a Gift From Congress Rebuild Public Confidence? Medicare reform is another way of digging out from under the PR muck. Make it work, make it better than it was before and even the industry's harshest critics will have to admit that managed care does good while it does well. Failure is not an option. mark for My Articles similar articles
Managed Care
August 2001
Interest in capitation backs off More than half of provider organizations surveyed by Evergreen Re, a national reinsurance consultant and broker, had at least one capitation contract last year -- but use of capitation fell dramatically from 1999 to 2000.. mark for My Articles similar articles
Pharmaceutical Executive
June 1, 2005
Jill Wechsler
Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs. mark for My Articles similar articles