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Managed Care October 2004	Kaiser Seen as Biggest Earner as HMO Profits Soared in 2003 The good times rolled on for the nation's HMOs in 2003. The industry nearly doubled its profits, earning $10.2 billion, an 86 percent increase from the $5.5 billion it earned in 2002.
Managed Care September 2005	HMO Profits up, But at a Much Slower Rate Overall, the HMOs' profits increased 10.7 percent in 2004, according to data collected from 515 managed care organizations.
Managed Care November 2002	Biggest one-year premium jump Health care premiums for large employers will increase 15 percent on average in 2003 -- the biggest year-over-year jump since Towers Perrin began conducting the survey in 1989.
Managed Care December 2002 Frank Diamond	Blues on the Move The resurgence of what was once primarily known as the insurer of last resort has been breathtaking. Can it be sustained? Even better, replicated?
Managed Care November 2007	Underwriting Earnings Slow, But Investment Gains Soar First-quarter underwriting gains for the health insurance industry declined in 2007, while investment gains were up nearly 42% compared with the same period last year.
Managed Care December 2000	While Large HMOs' Finances Improve, Small Plans Suffer Several large MCOs, including WellPoint, Cigna, United Healthcare, and Oxford, have reported strong third-quarter earnings. However, 44 percent of HMOs reported losses, a large proportion of those being plans with fewer than 100,000 members...
Managed Care March 2006	Will HMOs' Robust Profits Make Good Political Fodder? Those looking for any excuse to bash HMOs, including political gain, will turn anything into a weapon, including a recent study pointing to healthy profits.
Managed Care September 1999	Sagging Fortunes Cited in Departure Of Humana's CEO
Managed Care January 2005	Headlines on Deadline... More on the pay-for-performance push... The nation's HMOs operated on a slim profit margin in the first three months of 2004... Health coverage is not a factor in determining the level of care children receive in the U.S... etc.
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 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...
Managed Care April 2000	Headlines on Deadline... Philadelphia's Jefferson Health System has threatened to drop Independence Blue Cross June 1 unless a new contract can be hammered out... Whether you're in an HMO or an indemnity plan, there's no difference in your likelihood of being hospitalized or having access problems...
Managed Care November 2003	Malpractice protection efforts seem to come up short Medical malpractice insurance premiums continue to rise, even as some states place caps on non-economic damages, according to a survey by Weiss Ratings.
Managed Care February 2001	2001 Could Be Good Year For Managed Care Industry Median earnings for managed care organizations are expected to grow 17 percent this year, according to a forecast by Merrill Lynch. The report suggests that while enrollment increases will remain tepid, well-positioned companies will benefit from increased market share...
Managed Care January 2001	More HMOs to fold, consolidate in 2001 More than six dozen HMOs have characteristics that put them in danger of going out of business, according to projections by InterStudy publications...
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....
Registered Rep. January 28, 2003	Weiss Study: Analyst Community Still a "Sell" Out A study of the ratings systems at 30 brokerage firms showed significant improvement in their identification of companies heading into bankruptcy. On the down side, though, a surprising number continue to recommend companies right up to the day they file for Chapter 11.
Managed Care March 2000 Mark D. Abruzzo	Beating Obesity Begins By Expanding Tort Reform It's been suggested that, in order to battle obesity, HMOs should use their collective information and knowledge to change their members' behavior....
Salon.com July 4, 2001 Alicia Montgomery	Could just anyone get a pacemaker like Cheney's? Not necessarily, HMO critics say. And Bush has already promised to veto a bill that would help patients get care as good as the vice president's...
Managed Care November 2005	Hmos More Solvent and Stable -- for Now With mergers and consolidations leading the way, there were fewer, and better run, companies with improved underwriting discipline.
Managed Care November 2000	For first time ever, HMO enrollment drops in 1999 National HMO enrollment fell by 400,000 last year, from its all-time high of 81.3 million. For at least two years, a wider array of managed care products and an ever-smaller pool of people still covered under indemnity plans slowed the rate of HMO enrollment growth...
Managed Care June 2001	Few Seem To Use POS Option To Go Out of Network Point-of-service plans, in which members can see an out-of-network provider for higher out-of-pocket cost, are among the options employers offer with increasing frequency...
Registered Rep. October 8, 2002 Rick Weinberg	Brokerage Firms Continued Recommending Floundering Companies: Weiss Survey A surprising 74% of the 62 brokerage firms that follow companies that filed for bankruptcy protection between May 1 and Aug. 31 continued to recommend those companies to investors even as they were seeking protection.
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...
Managed Care January 2002	To Save Money, Employers Reduce Number of Plans Offered to Workers The days of employers scrambling to provide a choice of health benefits packages to lure and keep employees may be ending. The New York Times reports that large companies across the country are sharply reducing the number of HMOs they offer...
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 June 2002 Jeffry R. Ellis	Third-Party Payers Don't Realize Burdens Placed on Pharmacists PBMs and HMOs, by imposing a workload that doesn't allow enough time for needed functions, seem to want pharmacists to fail, this author asserts.
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 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 April 2000	Fallout from the "new economy": claims payment slower than ever A new InterStudy Publications report says HMOs relied heavily on investor funds during the 1990s to cover medical and operational expenses, and premiums alone were not enough. The resulting cash crunch means health plans are taking longer than ever to pay claims...
Managed Care June 2003	HMO, Medicaid formularies exhibit surprisingly small differences When you compare HMO and Medicaid formularies for coverage in major therapeutic areas, you find that the differences are relatively small, with Medicaid plans being somewhat less stringent.
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 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 March 2007	NCQA Toughens Evaluation of PPOs Preferred provider organizations will be evaluated on the same set of standards, clinical measures, and patient experience ratings that the NCQA uses to evaluate HMOs and POS plans.
Managed Care October 2003 MargaretAnn Cross	Some HMOs See Dividends In Charging Deductibles This may be one way to regain profitability, though getting permission from government regulators may take some doing.
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 October 2002 John A. Marcille	Has the Time Come for NCQA To Get Tough With HMOs? Perhaps it's just coincidence. The National Committee for Quality Assurance issues its State of Health Care Quality report the same month that a study is published in the Journal of the American Medical Association that dismisses the idea of grading health plans. Talk about irony.
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 December 2000	Headlines on Deadline... Physician fees under Medicare will go up an average of 4.5 percent next year... The number of HMOs participating in the Federal Employees Health Benefits Plan dropped by 40 percent... The California Public Employees' Retirement System has seen a 40-percent increase in medical costs... etc.
Managed Care July 2000	Are Gatekeepers Failing To Control Specialty Costs? The importance of a gatekeeper in keeping costs down has been challenged again -- this time in a study that compares physician utilization for HMOs and point-of-service plans.
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 January 2001	When pressure's on, raises get better In this tight labor market, most large companies are offering competitive salaries to recruit top talent, while making pay raises attractive enough to retain good employees who are knowledgeable about the organization. This is, perhaps, doubly true for managed care organizations...
Managed Care April 2001 Frank Diamond	Why HMOs Could Thrive In the Economic Downturn It happened in the slump of the early 1990s, and it could very well happen again. Managed care feasts while other industries starve. People will still get sick, even in bad times...
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.