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Managed Care
April 2000 |
Humana Readies New Online Assessment Tool Turning to the Internet to help identify its high-risk members and monitor their care, Humana has embraced a Rhode Island company's new personal-health assessment tool...   |
Managed Care
April 2000 |
What Drugs Are Covered? Safety, Efficacy Matter Safety and medical effectiveness most determine whether a health plan will cover a new drug, according to a study in the March/April Health Affairs. Researchers polled chief medical officers or pharmacy managers at 53 plans.... |
Managed Care
April 2000 |
Liability Closer; Work on Physician Bargaining Begins A House-Senate conference committee expects to craft a compromise managed care reform bill by the end of this month. The sometimes contentious committee meetings have been punctuated by disagreement on liability.... |
Managed Care
April 2000 |
Headlines on Deadline... Philadelphia's Jefferson Health System has threatened to drop Independence Blue Cross June 1 unless a new contract can be hammered out... Whether you're in an HMO or an indemnity plan, there's no difference in your likelihood of being hospitalized or having access problems... |
Managed Care
April 2000 |
Fallout from the "new economy": claims payment slower than ever A new InterStudy Publications report says HMOs relied heavily on investor funds during the 1990s to cover medical and operational expenses, and premiums alone were not enough. The resulting cash crunch means health plans are taking longer than ever to pay claims... |
Managed Care
April 2000
Michael Levin-Epstein |
Congressional Anti-Kickback Battle Hinges on HCFA's Regulatory Stance In an election year, the political hot buttons -- the Patients Bill of Rights and a Medicare prescription benefit, and maybe the issue of medical errors -- are sure to get a lot more attention than such mundane things as laws that would address potential kickbacks.... |
Managed Care
April 2000
Bob Carlson |
Many State Medicaid Agencies Use Financial Incentives To Boost Quality The days when state Medicaid agencies were bureaucratic establishments that paid claims and were unable to demand little better than institutional-style care are gone.... |
Managed Care
April 2000 |
Physician payment may hinge on quality, not quantity, in 2010 The Institute for the Future, a not-for-profit research group, suggests that over the next 10 years, performance-based payment mechanisms will gain popularity.... |
Managed Care
April 2000
Michael S. Victoroff, M.D. |
Helping Marginally Covered May Take Public-Private Effort Opening medicine's doors to a broader population has invoked the law of unintended consequences. Primary care physicians feel an increased demand for visits, referrals, and advice. ... |
Managed Care
April 2000
Mark D. Abruzzo, J.D. |
Despite What You Hear, State Privacy Statutes No Threat to DM In Managed Care's November 1999 issue, Al Lewis, president of the Disease Management Association of America, wrote about potential pitfalls facing DM. One identified by Lewis was state privacy laws, a topic that merits further attention.... |
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