Even with hospital money and PPO experience behind you, getting a new HMO started is a daunting proposition. Here's the step-by-step story of how one Louisiana health plan took the plunge.
If Congress tightens the belt on Medicare HMOs, it could slow the march of elderly Americans into managed care, creating complications for physicians. But that march won't be stopped.
The momentum in managed care has shifted to for-profit plans, but don't count out not-for-profits, particularly these three innovative and — for many enrollees — beloved HMOs. They aren't resting on their laurels.
This noted internist and lifelong Angeleno has nothing against the art of medicine. He just wants to complement it with the most rigorous science available.
Behavioral health care organizations, argues this administrator, are being monitored to death. He suggests that a set of ground rules be applied to avoid duplication and ensure fairness to all parties.
In police lingo, 'SWAT' stands for Special Weapons And Tactics. It's an apt metaphor for the team of workers a physician's office can assign to Solve Worrisome Account Troubles.
A few years ago, experts predicted that HMOs would be lining up exclusive "teams" of primary care physicians, specialists and hospitals. Today they don't agree whether that prophecy was wrong or has simply been delayed.