A few years ago, experts predicted that HMOs would be lining up exclusive "teams" of primary care physicians, specialists and hospitals. Was that prophecy wrong, or is its fulfillment just delayed?
The momentum has shifted to for-profit plans, but don't count out not-for-profits, particularly these three innovative andfor many enrolleesbeloved HMOs. They aren't resting on their laurels.
Behavioral health care organizations, argues the administrator of one, are being monitored to death. He suggests that a set of ground rules be applied to avoid duplication and ensure fairness to all parties.
Director of health services research at Cedars-Sinai Medical Center in Los Angeles and consulting medical director for PrimeHealth, Weingarten talks of guidelines, profiling and other management systems.
Even with hospital money and PPO experience behind you, getting a new HMO started is a daunting proposition. Here's the candid, step-by-step story of how one Louisiana health plan took the plunge.
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.
If Congress tightens the belt on Medicare HMOs, it could slow the march of elderly Americans into managed care, creating complications for health plans and physicians. But that march won't be stopped.