Managed Care

 

 

April 1996

It's all well and good to know that H. pylori causes peptic ulcer disease. But putting this knowledge to work curing ulcers — and saving money — means making sure the patient actually takes the pills.
Linda Wolfe Keister
Managed care owes much of its financial success to the "gatekeeper" system. But some health plans are tinkering with that model in hopes of providing care even more cost-effectively.
Anne Bilodeau
The "gatekeeper" model for controlling health care utilization is inherently flawed, argues this physician, who says substituting a more flexible system could save money as well as improving health care.
Lloyd M. Krieger, M.D., M.B.A.
In drawing up contracts, HMOs aren't shy about asking for terms favorable to themselves. Here, five health care attorneys discuss the most outrageous HMO demands they've encountered. Watch out for clauses like these.
Deborah Epstein
Friends and foes of "any-willing-provider" legislation don't line up as predictably as they once did. And even in the states that have enacted such laws applying to physicians, AWP is turning out to be a less ferocious beast than its backers had hoped.
David L. Coleman, J.D.

Meetings

4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015