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Managed Care
November 2000
Health Care Issues Force Prosecutors In Many States To Try New Approaches Virtually every item in the news about health care coverage lately, from HMO horror stories to health plan consolidation, from lawsuits to new legislation, means more work for some state's attorney general... mark for My Articles similar articles
Managed Care
October 2003
Ed Silverman
Tough Negotiations in Store Between Plans and Hospitals Fallout from the Medicare outlier-payment scandal is likely to force hospitals to try to replace that revenue. Health plans, prepare to negotiate! mark for My Articles similar articles
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... mark for My Articles similar articles
Managed Care
May 2001
Bob Carlson
Real Story in CalPERS Talks Lies Beyond the Headlines True, the rest of the country doesn't always follow California's lead. But you'd probably be right if you viewed the California Public Employees' Retirement System's April deal with eight HMOs as an omen... mark for My Articles similar articles
Managed Care
March 2004
Hospitals Retain Bargaining Edge In Contract Talks Contract negotiations between health plans and providers, primarily hospitals, were mild in 2002 and 2003, compared to how they played out in 2000 and 2001. mark for My Articles similar articles
BusinessWeek
August 26, 2010
Peter Waldman
Sutter Health's Market Power Is Questioned Insurers say the Northern California hospital chain uses its market clout to raise prices. mark for My Articles similar articles
Managed Care
February 2002
Mick L. Diede & Richard Liliedahl
Getting on the Right Track Converging forces are an economic train wreck waiting to happen. Avoiding a disaster requires an understanding of the interconnection of health care's stakeholders and the global consequences of their actions... mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
March 2002
Mildred Beam-Rucker
'Team Approach' to Contract Talks Means That Nobody Feels Cheated Managed care is a business. Both parties want a profitable relationship, and while profitability is important, providers and managed care organizations seem to have more success when they identify a joint mission for the relationship and take a team approach to contracting... mark for My Articles similar articles
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. mark for My Articles similar articles
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... mark for My Articles similar articles
Managed Care
September 2001
Jack McCain
Minnesota Buyers Coalition Back On Feet, Plans Expansion An employer group called Minnesota's Buyers Health Care Action Group (BHCAG) tries to contract directly with local groups of health care providers. After setbacks, they're still at it... mark for My Articles similar articles
Global Services
October 7, 2008
Namita Goel
Managing Disputes Who suffers the most in case of a dispute -- customer or service provider? Whose fault is it anyway? Who's holding the ball at the time of deal termination or disagreements? Is it possible to carry on an outsourcing relationship after a nasty scrap? Here's a reality check 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
March 2002
6 Large California Plans Link Doc Bonuses, Quality In what's being touted as an unprecedented effort, doctors and hospitals in California will be rewarded with bonuses of at least 5 percent for quality under a common set of standards adopted by six HMOs... mark for My Articles similar articles
Nursing Management
April 2009
Sharon H. Pappas
Profits, Payers, and Patients: Responding to Changes Profit is necessary for hospitals to fulfill their missions, invest in expansion and new technologies, and reinvest in existing patient care infrastructures. Profitability is the work of the financial team and the clinical team to produce the hospital's desired financial outcome. mark for My Articles similar articles
Managed Care
June 2003
Maureen Glabman
Managed Care Makes It Tough For Some Hospitals To Stay Afloat True, there are other reasons the facilities have closed, but insurers' payment rates stand out. Is it better that some are history? mark for My Articles similar articles
Managed Care
July 2002
Frank Diamond
Premium Hikes: No Cause for Celebration Lost market share and further erosion of public trust will be the long-term by-products of this short-term solution. 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
December 2000
Capitation rates see large boost While many physicians argue that HMOs are stingy about passing along revenue from premium increases, a new study suggests otherwise... mark for My Articles similar articles
Managed Care
January 2007
Headlines on Deadline ... State budgets got an unexpected gift last year... Mortality rates for hospitals ranked high... It looks likely that Massachusetts Gov. Mitt Romney will run for president... etc. mark for My Articles similar articles
Managed Care
December 2006
NCQA Rankings Give Edge to Not-For-Profit Insurers No sooner had the quality rankings of health plans in the nation, as measured by the National Committee for Quality Assurance, been released then it was pointed out that most of the top performers were not-for-profit insurers. mark for My Articles similar articles
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... mark for My Articles similar articles
Managed Care
April 2000
Mark Abernathy
Avoid Common Problems In Risk-Sharing Contracts These arrangements too often become a hindrance instead of a help. Simple precautions today can help prevent major headaches later on. mark for My Articles similar articles
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.... mark for My Articles similar articles
Commercial Investment Real Estate
May/Jun 2013
Mauldin & Maddron
Medical Office Momentum The Affordable Care Act takes some risk out of healthcare property investment. mark for My Articles similar articles
Managed Care
September 2001
30,000 in Calif. Forced To Find New Physicians Health Net, the California insurer, is dropping a large Orange County health system from its provider panel, forcing 30,000 members to find new doctors -- or a new health plan... mark for My Articles similar articles
Managed Care
July 2001
John Otrompke
Stark Allows Federal Regulators To Review Claims Records Fully HMO executives, as well as the providers and physicians who contract with them, should have by now felt the changes in their daily work lives resulting from the government's increased scrutiny of health plans' operations under the fraud-and-abuse compliance laws... 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
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. mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
January 2001
Richard B. Dwore
Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction... mark for My Articles similar articles
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? 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
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. 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
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... mark for My Articles similar articles
Managed Care
May 2000
Headlines On Deadline... Insurance briefs mark for My Articles similar articles
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. mark for My Articles similar articles
Managed Care
December 2006
Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs. mark for My Articles similar articles
Managed Care
August 2001
Frank Diamond
Consumers Dare You to Just Say 'No' The backlash has helped push a Patients' Bill of Rights forward, challenging the very nature of cost containment. Ironically, enrollees may be shortchanged... mark for My Articles similar articles
Commercial Investment Real Estate
Nov/Dec 2011
Thomas E. Gibbs
Avoidance Behavior Learn to resolve disputes before they occur. Mediation, arbitration, and other forms of alternative dispute resolution have become a favorable choice in today's commercial real estate market. mark for My Articles similar articles