Vol. 6, No. 8
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?
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.
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.
When employees can sign up or change benefits on line, plans and physicians can have immediate access to the information.
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.
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.
The University of Pennsylvania physician-economist calls for health plans to work together in their regions to create practice guidelines.
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.
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.
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.
Managing Editor's Memo 6
News and Commentary 9
Employer Update 21
Washington Initiatives 23
Compensation Monitor 27
State Initiatives 28
Legal Forum 127
Managed Care Outlook 130