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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. |
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... |
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. |
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 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. |
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... |
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... |
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. |
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. |
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. |
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.... |
Managed Care November 1999 |
Medicare Reform Dead for Now On Capitol Hill |
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. |
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... |
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? |
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... |
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. |
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 |
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.... |
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... |
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... |
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. |
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... |
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. |
On Wall Street November 1, 2012 Todd Colbeck |
Boost Your Medicare Expertise What every advisor should know about government insurance to better serve clients. |
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. |
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 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. |
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... |
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. |
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. |
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. |
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. |
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... |
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. |
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? |
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? |
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. |
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. |
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. |
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. |
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. |
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. |
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 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... |
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. |
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. |
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. |
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.. |
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. |