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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 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 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 July 2004 Martin Sipkoff	Managed Medicaid Business Might Be Worth the Difficulties Financial, regulatory, and access problems continue. Still, this remains a growth industry and some have found a way to profit.
Managed Care April 2000 Mark Abernathy	Avoid Common Problems In Risk-Sharing Contracts These arrangements too often become a hindrance instead of a help. Simple precautions today can help prevent major headaches later on.
Managed Care July 2000 Neville M. Bilimoria, J.D.	HMOs Continue Losing Ground On Liability Issues at State Level The recent U.S. Supreme Court decision offers a nice breather, but executives should not let down their guard, as an Illinois ruling shows.
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 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.
BusinessWeek February 17, 2011	Taking a Scalpel to Medicaid A look at eight key states whose governors want to cut costs for Medicaid.
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...
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 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 July 2000 Michael Levin-Epstein	Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen.
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 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 December 2006	Compensation Monitor More than half of the nation's HMOs use pay-for-performance programs.
InternetNews June 27, 2006 Michael Hickins	Hospital, HMO Ratings 'Open' to Public New York State adopts online scorecards allowing employers and consumers to review local hospitals and HMOs.
Managed Care January 2007	Headlines on Deadline ... State budgets got an unexpected gift last year... Mortality rates for hospitals ranked high... It looks likely that Massachusetts Gov. Mitt Romney will run for president... etc.
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 January 2001 Richard B. Dwore	Study An Opportunity for HMOs To Use Marketing To Increase Enrollee Satisfaction...
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.
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 November 1999 Michael D. Dalzell Senior Editor	HMOs, Physicians Discover They Really Need Each Other Some HMOs may be more willing than you think to help financially troubled medical groups survive. A willingness to cooperate is key.
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 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...
Managed Care October 2001 Bob Carlson	Trying To Get Control of Drug Costs, Florida Earns Kudos -- and a Lawsuit Pharmaceutical Research and Manufacturers of America (PhRMA) filed suit against Florida's Agency for Health Care Administration, challenging a new Medicaid formulary that requires manufacturers to pay supplemental rebates to have their drugs included...
Managed Care October 2007	Compensation Monitor How primary care doctors are paid affects quality in Medicaid MCOs.
Managed Care November 2005 John A. Marcille	Florida's Medicaid Waiver Will Be Scrutinized Closely Health and Human Services Secretary Michael Leavitt approved a Medicaid waiver application that will shift 210,000 beneficiaries in Broward and Duval counties into managed care beginning in July 2006.
Managed Care September 2004 John Carroll	Pfizer: DM Did Not Fizzle In Florida Medicaid Ruckus Medicaid officials close the books on a program the pharmaceutical giant contends that soon-to-be-released data will verify its disease management program's effectiveness.
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 September 1999 Frank Diamond	Consumers Join The Fray Electoral politics, the Internet, and much more sophisticated patients have all helped to redistribute power among managed care players.
Managed Care July 2000	Are Gatekeepers Failing To Control Specialty Costs? The importance of a gatekeeper in keeping costs down has been challenged again -- this time in a study that compares physician utilization for HMOs and point-of-service plans.
Managed Care July 2000	Bed days higher in smaller markets? Not with commercial plans When it comes to hospitalization, patients in cities have long spent less time in hospital beds than those in smaller markets. New data suggest this is still true for Medicare and Medicaid members -- but where commercial plans are concerned, the mean days-per-thousand figure was lowest in small markets.
Managed Care November 1999 Uwe Reinhardt, Ph.D.	Defined Contributions Will Point Employees Toward 'Health Marts' Companies will want to distance themselves from insurance entanglements, giving employees little option but to become more involved....
Managed Care August 2000 Mark D. Abruzzo, J.D.	Supreme Court Ruling Encourages Greater Awareness Among Patients To you and me, the court's holding in Pegram means that patients cannot sue HMOs under ERISA for giving doctors financial incentives to hold down costs. However, as is typical with many court decisions, this makes one wonder whether it doesn't take on a much greater meaning.
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 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 March 2000 Mark D. Abruzzo	Beating Obesity Begins By Expanding Tort Reform It's been suggested that, in order to battle obesity, HMOs should use their collective information and knowledge to change their members' behavior....
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...
Managed Care December 2002	California Puts Doctor Scores On Report Cards The competency of physician groups is often as important as HMO performance in determining patient outcomes, California health regulators have decided
Managed Care March 2002 Charles Downey	The Department of Managed Care California sets a precedent again, with a bold effort to regulate the HMO industry. While the new Department of Managed Health Care is facing down 50,000 consumer gripes monthly, director Daniel Zingale intends to keep administrative red tape from overwhelming everyone...
BusinessWeek February 21, 2005 Howard Gleckman	The New Face Of Medicaid Seniors and the disabled are pushing the program to the breaking point.
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.
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 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 February 2002	Where HMOs go head to head Almost three quarters (74.2 percent) of the 72.3 million HMO members in metropolitan areas are in large markets...
Salon.com October 21, 1999 Dena Bunis	Uninsured children A new report says there are still too many kids without health coverage.
Managed Care November 1999	U.S. Supreme Court To Hear Suit Against HMOs Over Incentives Can HMOs be sued for the practice of offering bonuses to physicians who help them keep the cost of care down?...
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 August 2001 Bob Carlson	States' Role as Policy Labs Tested as Resources Tighten State health-policy types point out that the State Children's Health Insurance Program (CHIP), the Health Insurance Portability and Accountability Act, the Patients' Bill of Rights and other federal initiatives came into existence only after states did the heavy lifting...