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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... |
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! |
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 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... |
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. |
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. |
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... |
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. |
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... |
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 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 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... |
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 |
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 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... |
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. |
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? |
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. |
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 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... |
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. |
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. |
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 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. |
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.... |
Commercial Investment Real Estate May/Jun 2013 Mauldin & Maddron |
Medical Office Momentum The Affordable Care Act takes some risk out of healthcare property investment. |
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... |
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... |
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 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 January 2001 Richard B. Dwore |
Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction... |
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 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. |
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 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... |
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 May 2000 |
Headlines On Deadline... Insurance briefs |
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 December 2006 |
Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs. |
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... |
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. |