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Managed Care December 2000 Mark D. Abruzzo	Some States Seek To Close Prompt-Payment Loopholes Many states have laws governing the timeliness of claims payments to physicians, hospitals, and other providers, but few such statutes have any real effect because of lack of enforcement or clarity. Some states are toughening their so-called prompt-payment laws, at the expense of insurers...
Managed Care June 2007	Which Insurer is Best at Paying Docs? Prompt and accurate payment by insurers is important to physicians. Here are the best and the worst insurers at paying.
Managed Care March 2005 William F. Jessee	What Do Physicians Want From Health Plans? Standardizing health plan administrative processes and eliminating duplication of effort would go a long way toward strengthening the doctor-insurer relationship.
Managed Care August 2002 Joyce Ochs	Managed Care's Use of Web Not Just for Marketing Anymore Virtually all MCOs today have Web sites as a matter of course. The challenge is to have a site useful enough to make people come back, while the operating challenge is to transfer selected company functions entirely or partially to the Internet to increase efficiency and reduce expenses.
Managed Care May 2004 MargaretAnn Cross	Will Providers Seek New Contracts As Consumer-Directed Plans Grow? Although plans are not restructuring fee schedules in consumer-directed health plans, providers think their agreements need fine-tuning.
Managed Care May 2000	Physicians Fudge Insurance Forms To Help Patients A study confirms what has long been considered common but is rarely discussed: Physicians often lie about patients' conditions to gain or improve coverage for their treatment.
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 October 2003 John L. Phelan	Pay Incentives to Physicians For Filing Electronic Claims Physicians' well-known reluctance to invest in office computer hardware and software is costing health plans money. How to get the docs' attention?
Managed Care April 2000 Karen L. Trespacz, J.D.	League of Their Own: What Makes a Winning IPA? In a familiar cartoon, a professor writes long, learned equations on a blackboard. To connect the profundities on either end, he writes in the middle, "Then a miracle occurs." IPAs, done well, are the miracles that connect the ends of health care.
Managed Care December 2000 Maureen Glabman	Downstream Without a Paddle State legislatures that tackle medical group insolvencies have come up with strategies that sometimes shift accountability to HMOs...
Managed Care October 2005 Bob Carlson	What Docs Hate Most About Plans Some insurers seem to have a knack for irritating their network physicians. The list is long, but five categories of irritants seem to recur most often.
Insurance & Technology November 14, 2007 Karen Ignagni	Technology, Innovation Enable Health Insurers To Address Challenges The health insurance industry will continue to innovate and provide new tools to improve the quality of care and contain costs while working with government leaders to ensure Americans have greater access to affordable coverage.
Commercial Investment Real Estate Sep/Oct 2009 Andrew Dick	Deal Diagnosis Healthcare real estate transactions not only are driven by economic factors, but also by compliance with federal and state healthcare laws.
Insurance & Technology August 2, 2010 Nathan Golia	PHRs Gain Popularity Among Insurers Health insurers are looking to consumer-directed online personal health records as a way to encourage members and providers to share updated healthcare information.
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 October 2007	Family Physicians Give Payers Middling Grades Results of a survey conducted by the American Academy of Family Physicians and Family Practice Management magazine indicate that health plans have issues to work on.
Managed Care May 2007 David A. Sparrow	Pay for Performance: As Much About Costs as About Quality You don't really have a true pay-for-performance program if it doesn't say so on the bottom line.
Managed Care August 2006 Emad Rizk	Finding Opportunity Where Business Models Meet The next stage of payer-provider collaboration will add true value.
Insurance & Technology August 18, 2010 Nathan Golia	Insurers Take Lead in EHR Implementation With guidelines for meaningful use of electronic health records established, health carriers expect IT improvements on the provider side to lower healthcare costs by reducing care redundancies and readmissions.
Insurance & Technology August 26, 2004 Peggy Bresnick Kendler	Smart Payment Options Card payments promise to increase consumer convenience and streamline transaction processing, but for insurers, they represent a new business - with new technology challenges.
Managed Care September 2001 Michael D. Dalzell	Where Will Health Plans Find The Next Generation of Savings? The industry realizes that it needs to get creative -- or perish, at least in the form it has taken. Employers won't stand long for double-digit premium hikes. With much of the fat already wrung out of care delivery, where will health plans find that next generation of cost savings?
Managed Care October 2000 Maureen Glabman	Giving Some Ground to Physicians Helped Turn Health System Around One hospital system accepted the general wisdom a few years ago by acquiring physician practices. Now it bucks the new wisdom by holding on to them...
Managed Care September 2004 Tony Berberabe	Can Physician and Health Plan Get Together Over Guidelines? Physicians are not the only problem. Health plans too often view guidelines as rigid routines rather than flexible aids to good practice.
Managed Care June 2004 Tony Berberabe	Welcome to the Brave, New (Electronic) World, Doctor WellPoint is providing free handheld or even desktop computers in an effort toward minimizing medication errors. Will docs finally abandon pen and pad?
Managed Care April 2007	A Conversation With Emad Rizk, MD: Disease Management Beyond the Call Center The man who heads McKesson Health Solutions, the third largest disease management program in the country, says it's time to roll out a new model.
Managed Care July 2005 Stanley Hochberg	Insurers Can No Longer Afford Not To Share Some Data Pay-for-performance programs imply improved patient care, but are frustrated by fragmented data collection and reporting systems.
Managed Care November 2004	Abandonment of Capitation May Inflate MCO's Costs Medical groups and IPAs in strong managed care markets are significantly less likely to use fee-for-service methods to pay their physician members than are organizations in markets with less managed care presence.
Managed Care September 2003	Primary care pay falls again Primary care physicians' compensation continues to decline, according to the American Medical Group Association's 2003 Medical Group Compensation and Productivity survey.
Insurance & Technology September 13, 2010 Nathan Golia	Virtual Roundtable: Improving Health Insurance Claims Processing Industry experts discuss potential areas of improvement in the healthcare claims process.
Managed Care May 2000	Texas-Aetna Incentives Settlement Worries Some Capitated Physicians If the Texas deal ignites a trend away from the use of incentives to keep utilization down, then some capitated physicians worry it will put them in a tight spot.
Managed Care June 2007 MargaretAnn Cross	What the Primary Care Physician Shortage Means for Health Plans Insurers fear rising costs and poorer outcomes if members are less able to get appointments with family physicians and general internists.
Managed Care May 2002	House Weighs Giving Parity To Mental Health Mental health parity has resurfaced as a legislative initiative. A bill would require that insurers' level of mental health coverage be on a par with physical health coverage
Managed Care August 2001	In Calif., Bonuses Based on Quality, Not Cost Savings Blue Cross of California has decided to move away from the traditional managed care incentive of rewarding physicians for controlling medical costs, and instead will implement a program in which physicians receive bonuses for quality of care and patient satisfaction...
Insurance & Technology August 9, 2010 Nathan Golia	Humana, Athenahealth Partner to Spur EHR Adoption The health insurer joins a growing list of peers providing financial or other incentives to providers to adopt electronic health records.
Managed Care April 2000	With AMAP Gone, Quality Judgments In Hands of Others When the American Medical Association shut down its physician accreditation program, AMAP, last month, several physician leaders expressed concern that the profession had lost its best chance to demonstrate efficient, high-quality care....
Managed Care July 2001 Harry L. Leider	HMOs Need To Share Gains of DM Programs Physicians are more likely to buy in if they see better outcomes -- and financial rewards that go with them...
Pharmaceutical Executive June 1, 2007 Jack Schember	Sales Management: Cleaning House A well-maintained database is the key to maximum doctor outreach.
Managed Care January 2005 Alice G. Gosfield	P4P: Transitional at Best Pay-for-performance (P4P) programs promise a fair shake for provider and insurance plan, but a former chairman of the National Committee for Quality Assurance sees many design flaws to overcome.
Managed Care November 2000 Jeffrey J. Denning	How's Your Office Manager Doing? Don't Let Question Just Hang There Every worker needs a performance review at least once a year. So, who reviews the reviewer? You do...
AskMen.com April 15, 2001 Joshua Levine	Choosing The Right Doctor Choosing a doctor is one of the most important decisions you can make. It's probably best made when you are healthy and have some time to think about a number of possibilities. If you don't have a doctor or are thinking about changing doctors, now may be the best time to look...
Managed Care December 2006 MargaretAnn Cross	Confronting The Medicare Cost Shift Plans are increasingly concerned about the degree to which providers overcharge them to make up for losses from government programs.
Insurance & Technology April 6, 2010 Anthony O'Donnell	Healthcare Reform Will Require Massive Insurance IT Spending Caught off guard by the passage of the Patient Protection and Affordable Care Act of 2010, insurers must modernize IT while increasing operational efficiency.
Managed Care May 2001	New Privacy Rules May Provide Boost For IT Companies For all the whining about HIPAA from providers and payers, there are reports that a growing share of them are beginning to see the value of it in long-term savings...
Managed Care November 2007	Headlines On Deadline . . . Improving imaging test utilization is a hot topic among insurers and providers... Pairing Zagat's methodology with WellPoint is the idea for the upcoming launch of a new online survey tool... etc.
Managed Care July 2001 Maureen Glabman	Provider Shortage Puts HMOs In Bind Increasing demand for physicians and physician extenders is starting to strain the system. To a large extent, this is unexpected bitter fruit of managed care's labor...
Managed Care December 2002 Diane Cook	Beware the Hidden Consequences of the Malpractice Crisis Soaring malpractice insurance rates are thinning out provider ranks in at least a dozen states. Could access problems pose issues for HMOs in those areas?
Managed Care June 2005 Martin Sipkoff	The Re-Emergence of the Primary Care Physician A new model of care developed by the American Academy of Family Physicians places primary care physicians back at the center of care delivery.
Managed Care May 2004 Martin Sipkoff	Will Pay for Performance Programs Introduce a New Set of Problems? Paying incentives to physicians to practice evidence-based medicine appears to be an idea whose time has come. Such programs -- even if successful -- may create a new set of problems.
Managed Care July 2006	Physicians' Real Income Continues to Fall Adjusted for inflation, physicians' net income from the practice of medicine declined 7% between 1995 and 2003, according to a national study.
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.