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Managed Care October 2002	Though M+C Erosion Slows, Reimbursement Still an Issue The exodus of health plans from Medicare+Choice will moderate somewhat next year, offering hope that the struggling system can make a comeback.
Managed Care May 2005	Implementing Medicare Part D Could Get Ugly This expert who hopes to help everybody adjust, nevertheless expects big headaches come Jan. 1, 2006. However, e-prescribing could make the drug plan work.
Managed Care July 2003 Patrick Mullen	Adviser to Presidents Considers Politics and Reform Change comes slowly, says this public policy expert whose work over the last two decades has helped frame the health care debate. She'd like to see greater efforts in the public and private sectors to reward quality.
Managed Care May 2006 John Carroll	Medicare Debates Fairness of Pay For Primary Care and Specialists A growing controversy in MedPAC and in physician organizations could spill over into how all health plans compensate doctors.
Managed Care September 2006	We Can't Avoid Tough Decisions Forever Former Reagan administration official Jeanne Scott is working to change how health information is processed. However, that's only part of the solution.
Managed Care September 2002	Medicare holds down physician pay Compensation increased at a comparatively small rate from 2000 to 2001 for both primary care physicians and specialists, according to the Medical Group Management Association.
Managed Care March 2006 Taylor & Eck	It's Time for CMS to Release Physician Medicare Claim Information The Center for Medicare & Medicaid Services is a rich source of price and quality data. Isn't it about time it shared that data?
Managed Care June 2003 John Carroll	Howard Dean, MD, Sees Universal Coverage as a Realistic Goal The former Vermont governor at first greeted managed care with good will. Now, however, he thinks it is shortsighted in its dealing with doctors. Unlike President Bush, he wouldn't call on it to rescue Medicare.
Managed Care July 2000	Lee N. Newcomer joins Vivius The former senior VP for health policy at UnitedHealth Group joins a company that aims to shift power from HMOs to patients and physicians.
Managed Care October 2000 Patrick Mullen	Interview: Steven B. Epstein, J.D. This pioneering medical legal authority says health plans and physicians should stop fighting over scraps the government throws them...
Pharmaceutical Executive August 1, 2013 Jill Wechsler	Costs and Coverage Challenge Medicare Drug Plans Rate cuts and fraud concerns create problems for Part D plans and Part B providers.
Pharmaceutical Executive April 1, 2007 Jill Wechsler	Washington Report: Medicaid Sets the Pace for Pharma Pricing Forget Medicare price negotiations. Pending changes in Medicaid drug-pricing formulas will put even more pressure on pharmaceutical prices.
Managed Care October 2001	CMS Defends Plan To Let States Tailor Medicaid Benefits Centers for Medicare and Medicaid Services Administrator Thomas Scully has defended the Bush administration's plan to allow states to opt out of mandatory Medicaid-coverage requirements...
Managed Care April 2006 John Carroll	Some Specialist Societies Feel Left Out of AMA-CMS Deal on P4P Many physicians question the fairness of a deal between the American Medical Association and the government that give doctors a bonus when they follow certain rules.
Managed Care March 2005	'This Country Cannot Continue With the System We Now Have' As a vice president of Pfizer Health Solutions, a major disease management company, John Sory knows how difficult it is to bring systematic care to the chronically ill. He discusses Pfizer's work with Florida's Medicaid program.
Managed Care August 2001	GAO: Consultants Point Docs Toward Federal Law Violations The General Accounting Office has found that some health care consultants have been advising physicians to do things that conflict with federal laws and that may be unethical...
Managed Care December 2007 John Carroll	How Doctors Are Paid Now, And Why It Has to Change Everyone knows about the perverse incentive of fee-for-service medicine, but that hasn't had much effect on its use.
Managed Care April 2002 Frank Diamond	Medicare+Choice: Uncertain Future for Unstable Program While policy makers haggle over President Bush's budget request for the system, an ominous question looms: Can money solve all the problems?
Managed Care July 2007	AMA: Patients Will Feel Cuts in Medicare Next year's proposed 10 percent cut in Medicare payments is serving as a rallying point for members of the American Medical Association, which says the cuts will make it difficult for physicians to accept new Medicare patients.
Managed Care September 2001	Personal Freedom Called Key to Coverage Tom Miller, the director of health policy studies at the Cato Institute, says choice matters more than antiquated systems...
Managed Care February 2005	Different methods used to gauge doc performance Just how physician performance is measured has become more important as P4P programs proliferate.
Managed Care December 2000 Patrick Mullen	Employer Demands Will Change Healthcare The CEO of a large Florida employer coalition insists that the information that companies are beginning to demand will force the industry to change...
Managed Care October 2001 Patrick Mullen	Interview: Pharmacists in Need The executive vice president and CEO of the American Pharmaceutical Association says pharmacists are being inundated and need help...
BusinessWeek October 10, 2005 Howard Gleckman	Medicare's Big Experiment The coming changes to Medicare aim to cut costs while improving care. Sound familiar?
Managed Care December 2001	CMS Medicaid Managed Care Proposal Under Close Scrutiny Bioterrorism. Medicaid managed care plans. No link between them? Guess again. It all has to do with how proposed Medicaid regulations would affect patients' rights and funding for Medicaid programs ranging from nursing home care to emergency rooms...
BusinessWeek February 21, 2005 Howard Gleckman	The New Face Of Medicaid Seniors and the disabled are pushing the program to the breaking point.
Managed Care May 2003	Program Rewards Physicians For Delivering High-Quality Care Bonuses for delivering high quality care will be the focus of a three-market program spearheaded by the National Committee for Quality Assurance and supported by a coalition of physicians, health plans, large employers, and the Centers for Medicare and Medicaid Services.
Pharmaceutical Executive November 1, 2005 Rubinstein & Galardi	Bustin' a CAP: The Competative Acquisition Program The new Competitive Acquisition Program for Medicare Part B drugs aims to align market forces with the distribution of drugs and biologics that doctors administer in their offices, but increasing bureaucracy is a major downside.
Managed Care March 2008	CMS Hybrid Payment System Shows Promise Combining Medicare fee-for-service payments with new incentive programs could help physician groups save money for Medicare and reach quality-of-care targets.
Managed Care October 2001 Michael Levin-Epstein	Medicare+Choice Reform: Hope, but No Quick Action Expected There have been small accomplishments, and wheels have been churning for more forceful action -- that is, they were until Sept. 11...
Knowledge@Wharton July 30, 2003	Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall.
Pharmaceutical Executive February 1, 2007 Jill Wechsler	Washington Report: Bundled Together Democrats and Republicans are making waves over whether government drug-pricing policies also raise concerns about drug safety and treatment practices.
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 March 2000	Tracking the Tracker of Health Care's Trends The president of the Medical Group Management Association encourages changes that would bring physician practice and medical record-keeping in step with the times, and decries the lack of medical standards across plans.
Managed Care January 2008 Marcia Naveh	Lax Coding by Physicians Hurts Medicare Advantage Plans By assisting doctors, insurers can get all the payment that they are due, but that too often is lost.
Pharmaceutical Executive October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
Managed Care July 2007 Tom Reinke	Better Ways to Pay Providers Paying for coordinating care and for packages of services -- bundling and episodes of care -- may be the best bet for a modification of the unfettered fee-for-service system.
Managed Care May 2006 Michael Levin-Epstein	Looking for a Better Way To Manage Care Can primary care physicians persuade health plans and Medicare to accept their version of the chronic care model?
BusinessWeek July 14, 2003 Howard Gleckman	This Medicare Reform Is No Cure The theory: The shift will improve treatment and save taxpayers money, helping to rein in ballooning Medicare costs while offsetting the expense of the drug benefit. Those are laudable goals. Unfortunately, Congress isn't likely to achieve them.
Managed Care February 2008 Martin Sipkoff	Why Is It So Tough to Deliver On E-Prescribing's Promise? The push to mandate this electronic tool is increasing in intensity, but dealing with costs and coming up with standards remain obstacles
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Pharmaceutical Executive June 1, 2005 Jill Wechsler	Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs.
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 July 2001 Patrick Mullen	Interview: Lucien L. Leape, M.D. The way to reduce errors in health care is to change systems, says this Harvard educator. Punishment encourages people to cover up...
Managed Care March 2007 John Carroll	Democratic Agenda Places Medicare Advantage at Risk Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split.
Searcher October 2011 Stephanie C. Ardito	The Medical Digital: Navigating the Medicare Maze Since entitlement programs are the chief governmental programs under fire, I decided to revisit the healthcare bills passed back in March (H.R. 3590, the Patient Protection & Affordable Care Act).
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.
Managed Care June 2007	A Conversation with Jonathan Weiner, DrPH: Mixing Population-Based Care With Market Controls The United States' health care system needs consumer and market controls to succeed, but it can't rely on only those two factors.
Managed Care June 2005	Giving More Than a Nod To the Wave of the Future An interview with the director of regional informatics programs through the Vanderbilt Center for Better Health and Accenture professor of biomedical informatics about how his love of medicine and fascination with technology continue to drive his work in the field.
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.