November 1997

Tough Road Ahead for the AMA's Physician Accreditation Program

Way back when, credentialing was something done only by hospitals. Now, nearly every health plan must do a check on every physician. The AMA has a plan to lighten the burden. But will it work for all parties?

Joan Szabo

CAPITATION: STATE OF THE ART

The March of Capitation: Reversed or Just Delayed?

Contrary to many experts' predictions, per-member, per-month prepayment of managed care physicians isn't sweeping the nation. But it can't be counted out, either.

Peter Wehrwein

CAPITATION: STATE OF THE ART

'Contact Capitation' and its Cousins

Between fee-for-service payment and pure capitation, health plans are developing several alternative means of paying specialists. So-called "contact capitation" is one of them.

Bob Carlson

CAPITATION: STATE OF THE ART

The Future of Capitation In a World of Shared Risk

Will global capitation be the means of reducing HMOs to the status of third-party administrators? Experts differ on that one. But they agree that capitation, in its various forms, is here to stay.

Jean Lawrence

NCQA's Quality Compass Points to Plan Differences

The first comparative report of health plan performance produces surprising revelations — and a starting point for assessing a plan's quality. But some people caution not to read too much into the numbers alone.

Michael D. Dalzell

Must Doctors Lose Money With Managed Medicaid?

It didn't take a seer to predict that states would try managed care on their costliest health mandate. But only a seer today can be sure whether physicians will be able to live with Medicaid risk contracts.

Cliff Collins

Medicare's Transition To Managed Care

Zeneca Pharmaceuticals convened a roundtable of five experts in August to discuss the transformation of Medicare into a more flexible, multi-option system that loosens restrictions on physicians. They paid particular attention to the changes just enacted in the Tax Reform Act of 1997.

NEW OPTIMISM FROM THE 'FATHER OF THE HMO'

An Interview With Paul Ellwood Jr., M.D.

History has vindicated Paul Ellwood's prediction of a price-competitive health care market. Is he right again in saying the current trend away from integration will be reversed?