How Health Plans Do–and Don’t– Reward the ‘Best’ Physicians 29
Now that quality is an industry obsession, it makes sense to find ways of paying your “best” doctors more. But does “best” just mean immunizations and success in the patient satisfaction survey sweepstakes?
Disease Management Gains A Degree of Respectability 39
Not too long ago, disease management was viewed with widespread suspicion. But the evidence mounts that well-designed programs make medical sense and can help patients as well as the bottom line.
Cut Pharmaceutical Costs, But Mind the Legal Dangers 47
Health plans and physicians have every right to hold down the cost of pharmaceuticals, as long as patients aren’t harmed. But not everyone agrees on what cost-cutting actions are acceptable.
Online Employee Enrollment Systems Can Lower Costs, Improve Communication 60A
When employees can sign up or change benefits on line, plans and physicians can have immediate access to the information.
Managed Medicare’s Rapid Expansion: Enrollment May Triple in 10 Years 61
Accounting for 12 percent of federal spending this year and projected to consume 15 percent of the budget in 2002 if not reined in, the Medicare program in 1997 is on the road to profound change.
Health Care Systems Slow To Pursue Comprehensive Depression Management 69
While development of depression management programs has lagged behind other chronic conditions, emphasis is now being placed on early diagnosis and treatment coordinated by primary care physicians.
Interview: Alan Hillman, M.D., M.B.A. 75
The University of Pennsylvania physician-economist calls for health plans to work together in their regions to create practice guidelines.
How Three Physician Groups Faced the Issue of Capitation 88
With HMOs often insisting on paying physicians by capitation, doctors have to decide whether to base individual compensation on that system. Some go with the flow; others swim against it successfully.
- How Capitation Turned Red Ink to Black At Harris Methodist Health Systems
- Capitation Is for Specialists, Not for Primary Care Physicians
- Making the Transition From Productivity Compensation to Capitation
Does Managed Care Hamper Research? 114
Some academic researchers warn that emphasis on low-cost care means that health plans won’t support expensive research at academic medical centers. The industry says research is not being ignored.
Better Patient Communications Mean Lower Liability Exposure 119
Physicians and hospitals have always been subject to liability claims, but now health plans are becoming vulnerable too. Adverse events cannot be eliminated, but there are ways to reduce the danger.
DEPARTMENTS
Managing Editor’s Memo 6
News and Commentary 9
Employer Update 21
Washington Initiatives 23
Compensation Monitor 27
State Initiatives 28
Ethics 125
Legal Forum 127
Managed Care Outlook 130
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.