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Managed Care August 2000 Carey Lee Straetz |
Managing Medicaid Rolls Often State-by-State Affair Despite the strong economy, Medicaid enrollment may be slowly rising after a three-year decline. The challenges for serving this population are huge.  |
Managed Care February 2006 |
Managed Care Offered to More Medicaid Enrollees A chart illustrates the percentage of medicaid enrollees in managed care, for the years 1996 to 2004.  |
Managed Care January 2001 Bob Carlson |
Ohio Struggles To Rescue Managed Medicaid Program Health plans and providers in Ohio's beleaguered Medicaid managed care program, OhioCare, welcomed its per-member, per-month payment increases of more than 25 percent over the last two years...  |
Managed Care April 2005 John Carroll |
Can Managed Care Programs Rein in Medicaid's Runaway Budgets? Cadillac or Yugo care for the poor? Fee-for-service or managed care? The states have a lot on their minds as the Medicaid monster grows and grows.  |
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...  |
Managed Care August 2002 |
24 States Hope Pharmacy Plus Helps Medicaid Twenty-four states may gamble that providing a prescription drug program to low-income elderly who do not qualify for Medicaid could save them money in the long run.  |
Managed Care September 1999 Frank Diamond Senior Editor |
Florida Medicaid Moves Toward Direct Contracting Florida will soon test a program that could provide competition for HMOs serving the Medicaid population. Other states are watching.  |
HBS Working Knowledge July 14, 2006 Regina E. Herzlinger |
The Case for Consumer-Driven Medicaid The Medicaid program is a health insurance safety net for 52 million Americans, but the price tag threatens the financial stability of the states. South Carolina provides a model in consumer-driven healthcare.  |
Managed Care June 2003 |
For-profit, not-for-profit enrollment holding about steady While HMOs seemed to be losing enrollees to PPOs, the ratio of enrollees in for-profit and not-for-profit HMOs stabilized in the late 1990s, according to data collected by the Centers for Medicare and Medicaid Services.  |
Managed Care January 2001 David Ricks & Joe Suminski |
Nowhere To Go but Out? Tracking Medicare+Choice Managed Medicare's trouble may have something to do with underfunding or rich benefits, but for health plans, market share has a lot to do with it, too...  |
Managed Care January 2001 John Carroll |
Florida Leads the Way in Attempting Disease Management for Medicaid Officials across the country are watching to see whether the Sunshine State's innovation can save money...  |
BusinessWeek February 21, 2005 Howard Gleckman |
The New Face Of Medicaid Seniors and the disabled are pushing the program to the breaking point.  |
Salon.com October 21, 1999 Dena Bunis |
Uninsured children A new report says there are still too many kids without health coverage.  |
Registered Rep. September 18, 2013 Kevin McKinley |
Having Money and Getting Medicaid Clients who want to have both their money and Medicaid may want to purchase a specific type of long-term care insurance known as a "partnership" policy, currently available to residents in 31 states.  |
Managed Care May 2005 Martin Sipkoff |
Health Plans Undaunted By Medicare Part D Despite the seeming Gordian knot of regulations associated with Medicare Part D, health plans figure the benefit-to-risk ratio is squarely in their favor.  |
Managed Care July 2006 |
Education Concerns Push Back Florida's Medicaid Experiment The greatly anticipated meeting between Medicaid and managed care that's expected to take place in Florida has been delayed.  |
Managed Care August 2004 |
Medicaid Fees Rise, But Still Below Medicare A recent study reports that 30 states raised their Medicaid fees at or above the rate of inflation, including 10 that raised physician fees by more than 35%.  |
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.  |
Managed Care February 2007 |
Employer-Sponsored Insurance Coverage Rates Falling A new report says that that 61 percent of non-elderly Americans had employer-sponsored insurance in 2004, compared to 66 percent in 2000.  |
Managed Care December 2007 Martin Sipkoff |
Large Plans Do Well Under Part D, But Premium Hikes Cloud Future Profits should increase over the next two years for plans that stay the course, but politics and rising premiums may affect long-term results.  |
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....  |
BusinessWeek August 8, 2005 Howard Gleckman |
Radical Surgery For Medicaid? South Carolina Governor Sanford has a plan to slash costs - but a political battle looms.  |
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 April 2002 |
More Than Just 'Chipping' Away at Problem of Uninsured Children CHIP (the Children's Health Insurance Program) continues to grow by leaps and bounds. About 4.6 million children in the U.S. received coverage through CHIP in fiscal year 2001. That's an increase of 38 percent from fiscal year 2000...  |
American Family Physician February 15, 2003 |
Newsletter House Bill May Reclaim Title VII Family Practice Training Funds... Health Care Spending in the United States Increased by 8.7 Percent in 2001... Two Surveys Demonstrate Negative Economic Impact of Medicaid Reductions... AHRQ Releases Fact Book on Women's Health Care in U.S. Hospitals... FDA Establishes Task Force on Consumer Nutrition Health Information...  |
Managed Care April 2004 |
Medicaid DM To Get Boost From CMS The federal government plans to give Medicaid disease management a lift by matching the money states pay to run such programs.  |
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 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.  |
American Family Physician July 1, 2000 Rosemarie Sweeney & Toni Lapp |
Newsletter NRHA Names Rural Health Practitioner of the Year... Hotline Connecting Parents with Health Insurance for Children... U.S. Hospitals Receive Medication Safety Assessment Tool... One Half of Consumers Report Problems with Health Plans... Study Reports Medicaid Enrollment on the Rise...  |
Managed Care June 2004 |
Administrative Costs: The Price of Giving Consumers More Choice Private health insurance expenses not related to direct care services continue to rise, but the higher costs buy what people want.  |
Managed Care June 2003 |
HMO, Medicaid formularies exhibit surprisingly small differences When you compare HMO and Medicaid formularies for coverage in major therapeutic areas, you find that the differences are relatively small, with Medicaid plans being somewhat less stringent.  |
Managed Care February 2002 |
Hospital costs lead way in health care expenditures The share of the gross domestic product attributed to health care increased slightly more than overall GDP growth from 1999 to 2000 -- the first time that's happened in nine years...  |
Financial Planning February 1, 2005 DeFrancesco & Flory |
The Golden Years? As this country's baby boomers get closer to retirement, long-term care (LTC) will only grow in importance. Medicaid annuities may help clients preserve their assets, even if they're already in a nursing home.  |
Managed Care August 2002 Madeleine A. Estabrook |
Regulators Take More Interest In Role of PBMs in Health Care In a highly regulated industry such as health care, it is just a matter of time before every component of the industry comes under scrutiny and review. Pharmacy benefit managers are taking center stage now.  |
Managed Care December 2001 |
Economic Boom Over, State Health Budgets Besieged The National Association of State Budget Officers estimated that aggregate state shortfalls for fiscal 2002 could exceed $15 billion...  |
Managed Care December 2006 MargaretAnn Cross |
Confronting The Medicare Cost Shift Plans are increasingly concerned about the degree to which providers overcharge them to make up for losses from government programs.  |
Managed Care February 2005 |
Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.  |
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 June 2006 |
All Insurers Face Similar Spending Growth The rapid rate of growth in health spending relative to national income is raising concern among policymakers -- is the U.S. health care system financially stable?  |
Registered Rep. March 1, 2006 Janet Arrowood |
The Medicare and Medicaid Minefield As the population ages and life expectancy rises, so does the likelihood that more people will be needing long-term care and your financial advisory clients should know the hard facts about paying for it, because the costs can be staggering.  |
Reason February 2009 Ronald Bailey |
E.R. Crowding A study blames a rising population, a falling number of emergency departments, and understaffing that prevents stabilized patients from being admitted to other parts of the hospital.  |
American Family Physician June 15, 2005 Carrie A. Morantz |
Newsletter Medicaid Expected to Top States' Health Care Agendas in 2005... NRMP Rules Out Second Residency Match... CMS Proposes New Rule on Hospice Care for Medicare Patients... Congressional Bill Encourages Use of Health Information Technology... etc.  |
Managed Care March 2004 |
More State Medicaid Programs Use Preferred Drug Lists To Manage Costs Medicaid, enacted in 1965, is currently costing over $200 billion per year. With rapidly rising health care costs, including prescription drugs, state Medicaid budgets are feeling the strain. Here's what they're trying to do to manage.  |
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 July 2002 |
Despite Deficits, States Avoid Cutting Medicaid, CHIP Rolls Although states are straining to close budget deficits, they have refrained from introducing stringent eligibility requirements for the CHIP and Medicaid programs.  |
BusinessWeek February 21, 2005 |
Mooching Off Medicaid The state-run medical-care programs originally designed to help poor mothers and their children now increasingly pay for nursing-home care for seniors. While many of those seniors are genuinely poor, others are not. The rules should be tightened.  |
Managed Care October 2007 |
Compensation Monitor How primary care doctors are paid affects quality in Medicaid MCOs.  |
Managed Care November 2002 MargaretAnn Cross |
Should Consumers Be Present On an HMO's Board of Directors? More consumers on HMO and integrated-system boards might not bring the benefits that advocates expect, yet some plans do find them helpful.  |
| Knowledge@Wharton |
Major Health Care Reform Under President Bush Remains Elusive Three of the chief health-care challenges facing the United States are: finding a way to provide coverage for the millions of uninsured, reforming Medicare, and setting up a prescription-drug plan for the elderly. The White House is likely to make headway on only the third of these in the next two years.  |
Pharmaceutical Executive May 1, 2005 Erik Felker |
Elephant or Specialist? The Bush Administration has put in place the groundwork for new market forces that will forever change how pharmaceuticals are commercialized. Although the long-term impact of this change is not known, unprepared companies are at a serious disadvantage.  |