MANAGED CARE February 1998. ©1998 Stezzi Communications
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Vol. 7, No. 2
February 1998

Will HEDIS '98 Mean More Reliable Data?

NCQA has tightened plans' sampling and reporting procedures. And more plans will submit audited data. The agency hopes this will give purchasers better apples-to-apples comparisons of plans.

COVER STORY

Reinsurance: Are You on a Firm Footing?

Reinsurance, once a sleepy part of managed care, is changing. Provider stop-loss is where the action is, but health plans are also affected, as a once-clubby market is starting to grow larger.

A Conversation With E. Andrew Balas, M.D.

A physician with a degree in advanced mathematics argues that medicine should borrow a few principles from accounting to get a better handle on the real costs of health care interventions.

Oryx Links Outcomes With Accreditation

Hospitals and managed care organizations seeking JCAHO accreditation will soon begin to track outcomes. How the new Oryx requirements will affect their accreditations is still fluid.

The Pharmaceutical Care Controversy

As pharmacists expand their patient care roles, health plans and physicians disagree on whether it is the right thing to do. Both sides have sound arguments in what is shaping up to be a bitter turf war.

Asthma Programs Show Progress

Most HMOs now have programs to manage and track their members with asthma. Some asthma management programs have moved beyond promise, serving plans and patients well.

The Media's Icy Coverage of Managed Care

Most broadcast and print stories about managed care are neutral, but a study shows bad press is becoming more and more common.

Back Up Your Data!

One good crash is all it takes for medical practices to suffer for months. Now is the time to back up data--before it is too late.

DEPARTMENTS

Editor's Memo

News and Commentary
PhyCor-MedPartners Merger Falls Through; MedPartners CEO Resigns After Stock Crash
Health Expenses Held in Check, Rise Only 4.4%
Suit Aftermath: What Are HMOs' Softest Spots?
AAHP Members Embrace Its Patient Policies
JCAHO Agrees To Observe CARF Accreditations
Benefits News: Fertility, Vision Gain Attention
Smart Card A Great Idea, But When?
Are we undermanaging hospital care? [chart]

Washington Initiatives
Though Still a Priority, Reform May Take Back Seat as Privacy Issues Heat Up
Waivers Out For Medicaid Managed Care
New Home Health Caregivers Get OK From Medicare
MSAs Fall Short Of Expectations, Says GAO Report
2 More Groups May Be Formed To Push 'Quality'
FDA To Regulate Drug Company-Owned PBMs
Take as Needed...

State Initiatives
With California Task Force Report Done, Reform Focus Moves Back to Legislature
More Legal Woes Beset Oxford; CEO Search Begun
Massachusetts Governor Pushes HMO Reform Plan
D.C., Maryland Blues Plans Come Together
Alabama Picks Workers' Comp Service Manager

Compensation Monitor

Discounts to managed care exceed 28% of usual charges

Employer Update
QMAS Offers a How-To When It Comes To Measuring Care Quality Indicators

Ethics

Ethics and Integrity: Restoring The Credibility of Managed Care

Legal Forum

How You Can Get the Most Out of Contract Negotiations

Managed Care Outlook
What's behind increases in pharmaceutical spending?