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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 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 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...
Managed Care February 2002	Where HMOs go head to head Almost three quarters (74.2 percent) of the 72.3 million HMO members in metropolitan areas are in large markets...
Managed Care March 2001	Premiums outstrip medical costs for first time in 6 years Whether this pricing tactic helps health plans return to profitability remains to be seen, but it appears the industry's financial picture is brightening...
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 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 July 2000	Bed days higher in smaller markets? Not with commercial plans When it comes to hospitalization, patients in cities have long spent less time in hospital beds than those in smaller markets. New data suggest this is still true for Medicare and Medicaid members -- but where commercial plans are concerned, the mean days-per-thousand figure was lowest in small markets.
Managed Care June 2003	For-profit, not-for-profit enrollment holding about steady While HMOs seemed to be losing enrollees to PPOs, the ratio of enrollees in for-profit and not-for-profit HMOs stabilized in the late 1990s, according to data collected by the Centers for Medicare and Medicaid Services.
Managed Care September 2002 Patrick Mullen	Interview: Richard L. Hamer Market-research organization InterStudy's director says that the push for patients' rights has grown into a concern for quality directed mainly at doctors.
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 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	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 December 2006	Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.
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 January 2001 Richard B. Dwore	Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction...
Managed Care October 2000	Large HMOs Do Well While Small Ones Slide Weiss Ratings reports that the nation's HMOs lost a collective $187 million during 1999, despite the positive performance of most of the country's largest managed care organizations...
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 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 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 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 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 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 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.
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 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 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	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 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 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 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.
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....
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 March 2000	Headlines on Deadline... Congressional Budget Office estimate of employer premium increase from Bipartisan Managed Care Improvement Act... Dot MD, the first internet vanity domain... etc.
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 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.
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 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 April 2000	Financial Stability Of HMOs Called A Mixed Bag An HCIA-Sachs survey says the median HMO profit margin in 1998 was -1.7 percent, slightly better than in 1997. Forty-one percent of HMOs made money in 1998....
Managed Care June 2004	Providers Retain Upper Hand Over Health Plans Hospitals in recent years have been successful in getting higher rates, decreasing their exposure to risk and obtaining other advantageous contract provisions from health plans, according to a new study.
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 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.
InternetNews June 27, 2006 Michael Hickins	Hospital, HMO Ratings 'Open' to Public New York State adopts online scorecards allowing employers and consumers to review local hospitals and HMOs.
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 August 2001 John A. Marcille	The Patients' Bill of Rights: Is What They Want What They Need? Passage of the Patients' Bill of Rights, which may be imminent, may not go down as one of the great works of the world, but rather as the fruit of mob judgment: "HMOs -- bad"...