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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...  |
Fast Company April 2006 |
"MD" Doesn't Mean "Mostly Digital" How technologically backward are U.S. doctors? Here are some statistics.  |
Managed Care December 2007 |
Strong Support for Transparency, But Small Effect Expected on Costs Three quarters of health care leaders believe increased transparency -- the public reporting of quality and pricing by name of hospital, physician practice, or health care provider -- is essential to improve the performance of the United States' health care system, according to a survey.  |
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 December 2000 Patrick Mullen |
Employer Demands Will Change Healthcare The CEO of a large Florida employer coalition insists that the information that companies are beginning to demand will force the industry to change...  |
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.  |
Pharmaceutical Executive July 3, 2007 LeVine & Zucker |
Marketing to Professionals: Professional Promotion Through Patient Understanding Patient-feedback programs can go a long way in helping physicians understand which drugs work.  |
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 May 2003 |
Program Rewards Physicians For Delivering High-Quality Care Bonuses for delivering high quality care will be the focus of a three-market program spearheaded by the National Committee for Quality Assurance and supported by a coalition of physicians, health plans, large employers, and the Centers for Medicare and Medicaid Services.  |
Managed Care September 2007 Martin Sipkoff |
Go Carefully When Measuring Quality Gauging and rewarding good work in health care is a noble goal with potentially negative consequences.  |
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 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 November 2005 Frank Diamond |
Physicians and Plans Can Get Along Hill Physicians Medical Group, one of the largest IPAs in the country, has learned to deliver what managed care plans want  |
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 December 2006 Lola Butcher |
Employer Coalition in Step with President's Marching Order The National Business Coalition on Health has a head start on Uncle Sam's new insistence on transparency and accountability.  |
Managed Care March 2005 William F. Jessee |
What Do Physicians Want From Health Plans? Standardizing health plan administrative processes and eliminating duplication of effort would go a long way toward strengthening the doctor-insurer relationship.  |
Managed Care November 2003 Martin Sipkoff |
9 Ways To Reduce Unwarranted Variation Unwarranted variation in medical practice is costly -- and deadly. When the approach in one town is major surgery and in another, it's watchful waiting, you know there's a problem.  |
Managed Care September 2004 Tony Berberabe |
Can Physician and Health Plan Get Together Over Guidelines? Physicians are not the only problem. Health plans too often view guidelines as rigid routines rather than flexible aids to good practice.  |
Managed Care February 2007 |
Quality is Important, But Productivity Rules Despite a rise in the use of quality incentives to determine physician compensation, productivity remains the predominant determinant.  |
Managed Care May 2007 David A. Sparrow |
Pay for Performance: As Much About Costs as About Quality You don't really have a true pay-for-performance program if it doesn't say so on the bottom line.  |
Managed Care December 2005 |
Health Plan Medical Directors Doing Well Medical directors at health plans saw a 7.2% rise in mean direct compensation from 2003 to 2005.  |
Managed Care January 2006 |
Compensation Monitor A recent poll reveals that doctors distrust pay for performance programs.  |
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.  |
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.  |
CIO June 1, 2003 Alison Bass |
A Big Rollout Bust Computerized physician order entry (CPOE) systems can reduce medication errors by as much as 86 percent, and save hospitals and doctors' practices billions of dollars, studies show. Yet only 3 percent to 5 percent of American hospitals have fully implemented CPOE systems. What gives?  |
Managed Care April 2002 |
HHS Applies 'Common Sense' To Privacy Regs In what is being hailed -- or scorned, depending upon the source -- as a major victory for the health care industry, the Bush administration has issued proposed revisions to privacy regulations...  |
Pharmaceutical Executive January 1, 2013 Al Topin |
The Doctor-Patient Disconnect Doctor-patient conversations aren't always what we think; this basic interaction represents both a problem and an opportunity for today's drug marketers, says the author.  |
Managed Care December 2004 Martin Sipkoff |
A Better Case for Quality: Share the Savings! Brent James's research has led to a new and powerful vision of paying for performance that binds physicians, plans and hospitals together.  |
Managed Care August 2006 Emad Rizk |
Finding Opportunity Where Business Models Meet The next stage of payer-provider collaboration will add true value.  |
Managed Care October 2005 MargaretAnn Cross |
Just How Will CDHC Change Your Job? Medical directors are charged with many of the tasks that could help members make the most of consumer-directed health plans.  |
Managed Care February 2005 Tony Berberabe |
Information: It's Better When You Share Today's version of a community health information network, the regional health information organization, is a collaborative of health plans, health care providers, and hospitals in a given geographic area that collects patient information stored on a secure Web site.  |
Managed Care March 2004 Martin Sipkoff |
Can Transparency Save Health Care? If everyone can see what everyone is doing, we'll have better care at lower costs. First task: Create common standards.  |
Managed Care May 2000 |
Physicians Fudge Insurance Forms To Help Patients A study confirms what has long been considered common but is rarely discussed: Physicians often lie about patients' conditions to gain or improve coverage for their treatment.  |
Managed Care October 2000 Maureen Glabman |
Giving Some Ground to Physicians Helped Turn Health System Around One hospital system accepted the general wisdom a few years ago by acquiring physician practices. Now it bucks the new wisdom by holding on to them...  |
Managed Care October 2005 Bob Carlson |
What Docs Hate Most About Plans Some insurers seem to have a knack for irritating their network physicians. The list is long, but five categories of irritants seem to recur most often.  |
Managed Care July 2005 Stanley Hochberg |
Insurers Can No Longer Afford Not To Share Some Data Pay-for-performance programs imply improved patient care, but are frustrated by fragmented data collection and reporting systems.  |
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 June 2007 |
Headlines On Deadline ... NCQA has published an expanded set of measures, guidelines, and technical specifications...A new strategy proposed by America's Health Insurance Plans would create an independent entity to compare the safety... etc.  |
Managed Care February 2002 Alan M. Muney |
Evidence-Based Medicine Needs To Be Promoted More Vigorously This means using a carrot-and-stick approach with physicians. Those who respect the evidence should be rewarded; others should face penalties...  |
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 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 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.  |
CIO April 1, 2006 Michael Fitzgerald |
The Business Case for Paperless Medicine A strong argument can now be made that doctors in small and midsize practices should invest in electronic health records. Here's how to get your physicians on board.  |
Managed Care July 2007 |
Managed Care Outlook The future holds too few docs.  |
Managed Care January 2002 Ed Rabinowitz |
When Physicians' Skills Fail, Collaboration Beats Punishment New programs hold promise for rehabilitating sound physicians who have, for any number of reasons, lost some of the skills they started with...  |
Insurance & Technology August 18, 2010 Nathan Golia |
Insurers Take Lead in EHR Implementation With guidelines for meaningful use of electronic health records established, health carriers expect IT improvements on the provider side to lower healthcare costs by reducing care redundancies and readmissions.  |
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.  |
BusinessWeek June 23, 2011 Drew Armstrong |
The Simplest Rx: Check on Your Patient Doctors and insurers cut costs by sharing information.  |
Pharmaceutical Executive October 1, 2005 Jeffrey Tangney |
Alternative Media: Mobile Marketing Through PDAs, pharmaceutical marketers have found an efficient way to communicate with and educate physicians.  |
Managed Care June 2007 |
Docs Don't Exploit Electronic Prescribing While physicians were positive about the basic features of e-prescribing, products often lacked advanced features, or if they had them, physicians often did not use them because of implementation hurdles or their perceptions that the features did not add value.  |