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Managed Care December 2000 |
Massachusetts Voters Reject Universal Care Backers of one of this year's most closely watched ballot initiatives say money had everything to do with its defeat...  |
Managed Care December 2000 |
2 Federal Courts Differ Concerning External Appeals Almost 40 states have laws giving health plan members the right to seek external review of denials of coverage. Conflicting federal court rulings about states' authority to bind health plans to external review decisions have put their constitutionality in question...  |
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 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 December 2000 Michael Levin-Epstein |
Outpatient PPS Regulations Latest Source of Anti-HCFA Anger The Health Care Financing Administration continues to be one of the most besieged agencies in the federal government. Now, providers are attacking the agency's rules for the prospective payment system (PPS) for hospital outpatient services...  |
Managed Care December 2000 Bob Carlson |
3 New England States Prescribe Innovative Ways To Cut Drug Prices It's too soon to tell whether Maine's prescription drug price control law will survive a legal challenge by drug makers. But private efforts and another innovative strategy -- a plan by Maine, Vermont, and New Hampshire to purchase prescription drugs jointly -- are moving ahead...  |
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 December 2000 Joyce R. Ochs |
'E'-normous Change Afoot Will Alter Health Care Radically It is important to realize that what is happening in the health care industry as it moves to the Web and becomes e-health is similar to what is happening to business in general as it moves to the Web and becomes e-commerce...  |
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 December 2000 |
Ease of navigating system varies by condition Do patients with differing conditions have different experiences within the health care system? A sampling of California patients suggests that they do...  |
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