Managed Care - Health Online

Managed Care Articles

2006-06-20
Missiles, movies, healthcare
ModernHealthcare.com, IL - 12 hours ago became broader with the move with complete financial responsibility including debt structure, accounting and financial reporting, managed-care negotiations and
http://www.modernhealthcare.com/storyPreview.cms?articleId=40291&archive=N

2006-06-19
Does Your Health Coverage Need a Checkup?
VillageSoup Belfast, USA - Jun 16, 2006 These plans are unpopular and usually found in rural areas, as the managed care networks of most major carriers are better suited for metropolitan areas.
A point-of-service plan (POS) attempts to combine the freedom of a PPO with the lower cost of an HMO. A POS plan is based on a simple principle—lower medical costs in exchange for more limited choices. Like an HMO plan, you are required to choose a PCP whom you will see for all your medical needs, your “point-of-service” physician. Your PCP may elect to refer you to a specialist inside or outside of the POS network. If you are referred to someone outside of the network, your health insurance company may not offer 100-percent compensation. It is your responsibility to complete any necessary reimbursement paperwork and keep records of your medical expenses. For visits to specialists within the network, any necessary paperwork is completed for you.

2006-06-18
Insurer banned from signing new customers in managed care plan
WCAX, VT - Jun 9, 2006 ALBANY, NY State officials have banned the nation's second-largest health insurer's managed care plan from signing up most types of new customers, citing its
Captain Thomas D'Angelo tells the Rochester Democrat and Chronicle that the driver was found unconscious. He was taken to Strong Memorial Hospital, where he was pronounced dead.

2006-06-16
Excellus revises its dealings with doctors
Rochester Democrat and Chronicle, NY - 23 hours ago But the change also applies to a RIPA sister organization, Crossbridge Network, the doctor panel for other managed care products.
Starting in January 2007, Excellus will contract directly with doctors for most of its commercial products such as its popular BlueChoice HMOs, officials announced Wednesday. In doing so, Excellus is changing its relationship with the Rochester Individual Practice Association, or RIPA, which will no longer do financial contracts but instead do other advocacy and administrative work.

2006-06-15
Kaiser Notice Called Ample
Los Angeles Times, CA - Jun 14, 2006 Lynne Randolph, spokeswoman for the managed care department, said Kaiser attempted to broker a deal that would have allowed its members to continue seeing the
Redirect to http://www.latimes.com/news/printedition/california/la-me-kaiser14jun14,1,3188625.story?coll=la-headlines-pe-california&ctrack=1&cset=true

2006-06-14
Insurers expanding access to physician information on health care
Newsday, NY - 9 hours ago "The problem we've had in the past is if you had managed care with a $20 copay or traditional HMO, there's really very little incentive to care what the price
"While purchasing health care is a much different decision than buying a house or a car, we firmly believe that consumers should ultimately have access to exactly what they're demanding _ the same kind of objective cost and quality information that is readily available when making other significant purchases," Ronald Williams, chief executive and president of Aetna, said in a statement.

2006-06-13
Wellness programs are worth every dollar you spend
Bizjournals.com, NC - Jun 11, 2006 programs. However, many companies dropped wellness programs in recent years as they turn to managed care health insurance plans.
Wellness programs also help to recruit and retain the most effective, productive employees. Studies show a correlation between employees who seek out corporate wellness programs and the most productive workers. Morale is another benefit of a wellness program. These programs are inexpensive ways to show employees the organization is interested in them as total persons.

1. The impact of Medicaid managed care on hospitalizations for ambulatory care sensitive conditions
Objective. To determine whether Medicaid managed care is associated with lower hospitalization rates for ambulatory care sensitive conditions than Medicaid ...

2. The administrative control system of substance abuse managed care
Objective. This article searches for the dimensions of the administrative structures in outpatient substance abuse managed care that control the behavior ...

3. Cost shifting to jails after a change to managed mental health care
Objective. To determine whether managed mental health care for Medicaid enrollees in King County, Washington, has led to indirect cost-shifting to substitute ...

4. Socioeconomic disparities in the use of home health services in a Medicare managed care population
Objective. To investigate socioeconomic disparities in access to home health visits and durable medical equipment by persons enrolled in two Medicare ...

5. Managed care as a concept—meeting the challenge
Introduction Contributing to the start of a brand new service is both an exciting opportunity and a daunting challenge. Adur, Arun and Worthing Teaching ...