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Managed Care January 2004 Martin Sipkoff	Transparency Called Key To Uniting Cost Control, Quality Improvement NCQA President Margaret O'Kane and a panel of clinically oriented administrators call for emphasis on making the best care financially attractive to physicians, plans, and employers.
Managed Care October 2005	P4P Programs Used To Get Docs Online For both doctors and patients, health information is crucial -- that's what many pay-for-performance programs hopes to promote.
Managed Care May 2007 MargaretAnn Cross	Following the Leaders Top pay-for-performance programs point to increased focus on hospital incentives, efficiency measures, coordination, and standardization.
Managed Care May 2004 Martin Sipkoff	Will Pay for Performance Programs Introduce a New Set of Problems? Paying incentives to physicians to practice evidence-based medicine appears to be an idea whose time has come. Such programs -- even if successful -- may create a new set of problems.
Managed Care January 2005 Alice G. Gosfield	P4P: Transitional at Best Pay-for-performance (P4P) programs promise a fair shake for provider and insurance plan, but a former chairman of the National Committee for Quality Assurance sees many design flaws to overcome.
Managed Care July 2005 Martin Sipkoff	Is Pay for Performance Part of the Cure or the Problem? Paying for performance promises improved quality, reduced cost, and higher income for doctors. So why are some of them worried?
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 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 August 2001	In Calif., Bonuses Based on Quality, Not Cost Savings Blue Cross of California has decided to move away from the traditional managed care incentive of rewarding physicians for controlling medical costs, and instead will implement a program in which physicians receive bonuses for quality of care and patient satisfaction...
Managed Care September 2004	O'Kane Gives the OK To Focus More on Providers The head of the National Committee for Quality Assurance, Margaret E. O'Kane, says health plans want to encourage physicians in the never-ending quest for quality.
Managed Care March 2007 Martin Sipkoff	Plans, PBMs, Employers Prod Docs To E-Prescribe Widespread adoption of electronic prescribing is inevitable, yet physicians still resist. Various coalitions and initiatives are trying to make adoption easier.
Managed Care December 2002 Margaret E. O'Kane	Taking the Lead for Accountability Critics complain that some HMOs withhold data, but NCQA President Margaret O'Kane responds that HMOs are exemplary in measuring and reporting quality.
Managed Care January 2005	NCQA Hopes 10-Best Lists Spur Consumer Interest Medicaid Top 10: BlueCross BlueShield of Western New York... HealthPlus of Michigan... UPMC Health Plan... Medicare Top 10: Blue Cross and Blue Shield of Massachusetts... Capital Health Plan... HealthPartners... etc.
Managed Care March 2007	Achieving Quality Measures Yields High Bonuses for U.K. Physicians General practitioners in the U.K. make an average of about $108,000 each year, but incentives for improved quality, achieving clinical goals, and better services -- including better appointment systems -- can result in bonuses amounting to $92,000.
Managed Care June 2001 Frank Diamond	HMO/Physician Strain Creates Invisible Costs Perhaps goodwill is too much to ask for. However, peaceful coexistence can certainly help all players reach their mutual goal -- a smooth relationship that helps to get the job done...
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?
Managed Care October 2001	Physician Pay Used as Boost For Quality Momentum is building to use physician reimbursement and bonuses not just as utilization controls, but as quality-improvement tools...
Managed Care April 2005 Martin Sipkoff	Health Plans, Employers Join Forces To Promote E-Prescribing The e-prescribing movement is getting some new advocates --employers. Can the combined influence of plans, employers, and the government affect physician buy-in?
Managed Care November 2006 Martin Sipkoff	Rocky Mountain's Success with Chronic Care Model Paying for medical group practice redesign can significantly enhance the quality of care for chronically ill patients, and perhaps lower long-term costs.
Managed Care January 2006	Compensation Monitor A recent poll reveals that doctors distrust pay for performance programs.
Managed Care May 2002 Patrick Mullen	Interview: Thomas Scilly In a candid, wide-ranging interview, the Centers for Medicare and Medicaid Services administrator counsels patience in solving the myriad problems of health care. A fix could take 20 years
Managed Care August 2004	Free Database Encourages Wide Sharing of Information on Programs' Outcomes Yes, health care is a business, but altruistic plans would like to cooperate with others. The Leapfrog Group has set up a simple mechanism to do this.
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 May 2003 Martin Sipkoff	Working Together on the Medical Side Partly because of employers' demands, health plans are starting to cooperate in ways that improve care.
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.
Managed Care September 1999	Physicians Seen As Next in Line For NCQA Review The National Committee for Quality Assurance says it will begin an accreditation program for medical groups two years from now....
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 October 2007	Data on Quality Lacking for Docs A new report says that insurers are better at providing quality information about hospitals than about physicians.
Managed Care May 2007 John Marcille	Pay for Performance Proceeds at Proper Pace The incrementalist pay-for-performance will be with us long after Medicare private fee-for-service plan is history.
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 November 1999 Steve Wetzell	To Cure Risk Aversion, Employers Eye Risk Adjustment ...The more employers can get consumers involved in the game, the more providers will become directly accountable to consumers. Under traditional managed care, employers -- without realizing it -- have put themselves in the middle of the relationship between physicians and their patients...
Managed Care April 2007	Physicians Oppose Public Disclosure of Quality Although 3 out of 4 primary care physicians support the use of financial rewards as an incentive for better medical care, the majority would rather not make quality assessments readily available to the public, according to a recent survey.
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 March 2002	NCQA To Help CMS Monitor Quality of M+C Plans The National Committee for Quality Assurance has been tapped to help the Centers for Medicare and Medicaid Services (formerly HCFA) monitor plans that participate in Medicare+Choice...
Managed Care April 2006	Pay-for-Performance Champions Excited by California Program's Success A quality incentive program in California is yielding results that could be replicated in Medicare and other pay-for-performance (P4P) programs nationwide according to a new report.
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 July 2001 Harry L. Leider	HMOs Need To Share Gains of DM Programs Physicians are more likely to buy in if they see better outcomes -- and financial rewards that go with them...
Managed Care December 2004	Headlines On Deadline ... Preferred Provider Organizations participating in Medicare Advantage can satisfy federal oversight requirements if they've already received accreditation from the National Committee for Quality Assurance.
Managed Care April 2002	What's An E-Mail Consultation Worth? The answer depends on whom you ask. A search of news archives turns up two reported experiments with reimbursement of physicians for e-mail communication with patients...
Managed Care December 2006	Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.
Managed Care May 2007 Lola Butcher	Massive Databases Under Construction Insurers and employers are busily compiling databases to control costs and improve care, but physicians are laying claim to the data.
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?
BusinessWeek April 23, 2009 Catherine Arnst	Doctors' Pride: A Hurdle to Digital Medicine A forerunner in New England found that some physicians would sooner cut ties than see their elite status threatened.
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 May 2000	Texas-Aetna Incentives Settlement Worries Some Capitated Physicians If the Texas deal ignites a trend away from the use of incentives to keep utilization down, then some capitated physicians worry it will put them in a tight spot.
Managed Care December 2005 Ricardo Guggenheim	Putting EBM To Work (Easier Said Than Done) Through widespread implementation of evidence-based medicine, the United States has its best chance of erasing the variations in care that currently extract such huge costs -- both human and financial -- from the health care system.
Managed Care June 2001	'Quality of care' in eye of beholder The AMA, the Joint Commission on Accreditation of Health Care Organizations, and the National Committee for Quality Assurance have crafted a common set of performance measures for management of adult diabetes...
BusinessWeek May 29, 2006 Howard Gleckman	Medicine's Industrial Revolution Medical treatments that are proven to work reach only about half of the Americans who need them, according to a series of studies by RAND Corp. And in hospitals, simple measures that protect patients' lives are often hard to implement.
Pharmaceutical Executive July 1, 2011 Cabacungan & Clark	New Ways to Gain New Brand Insights If you can learn to understand patient and physician behavior, you are well on your way to strengthening the position of your product.
Managed Care October 2003 MargaretAnn Cross	Plans and Purchasers Team Up To Manage Kidney Disease Cooperation between three health plans has fostered better employer appreciation of early detection and intervention in kidney disease.