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Managed Care February 2001	Denver Docs Bolt Aetna Before It Ends 'All-Products' Some 8,000 Denver-area residents were left to find new doctors when 240 physicians affiliated with MedWest Medical Group dropped Aetna U.S. Healthcare in a dispute over contract terms. The doctors did not renew their Aetna contract when it expired Jan. 31...
Managed Care July 2002 John A. Marcille	Capitation as Whipping Boy: Court Takes on Touchy Issue If plans are to keep coverage decisions reasonable and fair, they'll need tools that involve physicians and patients in the decision-making process. Capitation is one of those.
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 October 2000	Physicians Praise New Aetna Stance On Kids' Vaccines In California, Aetna U.S. Healthcare has addressed a major complaint of the state's leading physician organization -- that relatively low capitation rates force pediatricians to eat the cost of recommended vaccines....
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 August 2000 Bob Carlson	'All Products' Clauses Fade From Physician Contracts All-products provisions in health plan provider contracts are slowly being negotiated, legislated, and regulated out of existence. They are now illegal in at least four states; legislation is pending in several others.
Managed Care November 2000	Aetna Opens Gate With Several New No-Referral Plans Aetna U.S. Healthcare will launch a series of products Jan. 1 that will drop the gatekeeper function. In most cases, the new plans, called Aetna Open Access, will allow members to receive care from specialists without a referral from their primary care physicians...
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.
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 October 2000	How you fare under capitation Warren Surveys talked to about 50 HMOs and community based health plans in 1999 to tally what they were paying physicians in capitation and risk-arrangement contracts...
Managed Care July 2002	Money isn't everything Physicians are fairly happy with their incomes, but unhappy with the number of hours they have to work, as well as with the ancillary duties involved in practicing medicine, according to a survey.
Managed Care October 2004	Does Payment Method Drive Procedure Rates? In a study involving three large HMOs, researchers reviewed encounter and claim data for specialty services associated with different rates of performance of invasive procedures.
Insurance & Technology September 14, 2004	Cyber News Aetna offers tools, Vision Insurance expands deal with eAutoClaims... Cigna adds toolkit... etc.
Insurance & Technology October 27, 2008 Nathan Conz	CIGNA's e-Learning Initiative Aims to Inform Public CIGNA has launched a multi-pronged, public-facing e-learning website aimed at providing basic education about the healthcare system and health insurance to members and non-members.
Managed Care November 2004	Abandonment of Capitation May Inflate MCO's Costs Medical groups and IPAs in strong managed care markets are significantly less likely to use fee-for-service methods to pay their physician members than are organizations in markets with less managed care presence.
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 February 2005	Class-Action Suit By 600,000 Docs Heading To Court Discusses a lawsuit filed by about 600,000 physicians against some of the biggest health plans in the country: Humana, PacifiCare, UnitedHealthcare, WellPoint, Anthem, and Health Net. Aetna and Cigna were named but settled out of court.
Insurance & Technology April 5, 2006 Anthony O'Donnell	In It Together Using client research, Cigna determined that the best offering for its employer health plan market was an integrated health savings account solution that offered a seamless experience for members and is partnering with JPMorgan Chase to provide it.
Insurance & Technology September 16, 2005 Katherine Burger	Educating Consumers A truly technology-enabled offering, the idea behind consumer-directed healthcare is that everyone benefits when consumers have more information.
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...
Insurance & Technology January 21, 2010 Katherine Burger	CIGNA Teams with MD On-Line to Grow Electronic Claims Submissions New initiative part of CIGNA efforts to offer providers enhanced service and reduced expenses.
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....
Managed Care August 2001	Interest in capitation backs off More than half of provider organizations surveyed by Evergreen Re, a national reinsurance consultant and broker, had at least one capitation contract last year -- but use of capitation fell dramatically from 1999 to 2000..
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...
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...
The Motley Fool December 29, 2006 Billy Fisher	2006 in Review: CIGNA A disappointing start didn't keep the health insurer down. CIGNA shareholders can hope for another strong year in 2007.
Insurance & Technology June 14, 2005 Wendy Toth	CIGNA Takes Bite Out of Claims CIGNA Dental has teamed with Post-N-Track Corp. to provide a new Web solution for the submission of claims.
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 July 2004	Hill Physicians Medical Group Outshines California's Pay-for-Performance Program Hill paid out twice the amount as the state plan because the medical group program is older and more mature.
Managed Care April 2000 Karen L. Trespacz, J.D.	League of Their Own: What Makes a Winning IPA? In a familiar cartoon, a professor writes long, learned equations on a blackboard. To connect the profundities on either end, he writes in the middle, "Then a miracle occurs." IPAs, done well, are the miracles that connect the ends of health care.
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...
CIO March 15, 2003 Alison Bass	Cigna's Self-Inflicted Wounds A cautionary tale about the perils of IT transformation and the dangers of counting your chickens before they hatch.
Managed Care August 2006	Headlines On Deadline ... Aetna is unveiling something it calls the Medicare Open Plan, targeted for employers who want to offer retirees age 65 or over a fee-for-service Medicare Advantage plan.
Managed Care August 2000	Nation's Only Medicare PSO Under Rubble of M+C Pullout There was a time when provider-sponsored organizations were the government's great hope for the spread of managed Medicare. But less than three years later, the nation's only Medicare PSO is cashing it in.
Managed Care June 2006	Fewer Doctors Contract with Managed Care Although it was stable in the mid-1990s, the proportion of physicians without any managed care contracts rose from 9.2 percent in 2000-2001 to 11.5 percent in 2004-2005, according to a report.
Managed Care November 2006 Arthur Lazarus	Expert Opinions Create Liability for Physicians Physicians cannot rely on courts, drug companies, or HMOs to protect their freedom of speech. Their experience and knowledge form the foundation of all medical opinion.
Managed Care July 2004	Headlines On Deadline ... In a major victory for HMOs, the Supreme Court voted unanimously on June 21 that patients may not sue health plans in state courts for refusing to pay for medical care recommended by physicians.
Managed Care March 2005	Physicians, Plan at Odds Over Autoworker Coverage The Michigan State Medical Society and the Michigan Osteopathic Association are suing Blue Cross Blue Shield of Michigan after the health insurer cut 500 doctors from its provider network. They allege the insurer is trying to strong-arm them into reducing physician fees.
Managed Care December 2007 John Carroll	New York Plan Emerges As Pattern for Rating Physicians The Empire State's approach to physician ratings quickly gains health plan support and consideration as a national answer.
Managed Care November 2006	Compensation Monitor Doctors say they're busy but underpaid.
Managed Care May 2000	The latest blow to managed care? The Texas attorney general's decision in the Aetna case is the latest in a long string of events that has gutted the fundamentals of managed care. Many in health care think that some or all of these developments have stripped health plans of their ability to manage care effectively....
The Motley Fool April 5, 2004 Alyce Lomax	Cigna's Good Medicine Cigna said that its better outlook is due to greater efficiency and better management of medical costs. It also touted some new product initiatives that are surely a way to try to retain membership as well as woo new members.
Managed Care October 2005	Salary Slowdown Reported for Specialists Compensation growth for specialists fell behind that of primary care physicians in 2004 for the first time in several years, according to a survey.
Managed Care May 2007	Self-Referral Persists Despite Stark II Law Loopholes in federal and state laws that curb physician referral to diagnostic imaging providers in which they have a financial stake (self-referral) are allowing physicians to stretch how they are paid and for what.
Managed Care September 2001	How well do for-profit plans value their executives? Last year, the highest-paid executives at 10 of the nation's largest for-profit health plans received an average compensation, including salary, bonuses, life insurance, retirement plans, and other compensation -- but not unexercised stock options -- of $11.7 million...
Managed Care September 2005	Headlines On Deadline ... WellPoint and Cigna are turning heads in the financial world... California health insurers have marked Jan. 1, 2007 on their calendars... etc.
The Motley Fool August 2, 2006 Stephen D. Simpson	CIGNA Stands Out A health insurance company actually pleases Wall Street. Who knew? Investors, take note.
Managed Care May 2006	Physician Disclosure Strengthens Patients' Trust Patients who received a disclosure felt more competent to judge the effect of their physician's compensation on their health care, and nearly a quarter of patients who remembered receiving a disclosure reported that it had increased their trust in their primary care physician.
Managed Care September 1999 MargaretAnn Cross	It's Too Soon To Write Off Those Suffering PHOs Lessons have been learned from early PHOs, which lacked direction and had misaligned interests between hospitals and physicians.
Pharmaceutical Executive May 1, 2006 Musacchio & Hunkler	More Than a Game of Keep Away The Prescribing Data Restriction Program takes effect in July. The AMA explains how individual doctors can keep their prescribing habits safe from reps, and how pharma can keep using the anonymous data -- if the industry polices itself.