Whatever Happened To Exclusive Contracting? 36
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?
Pioneer Not-for-Profit Plans Struggle To Remain Leaders 48
The momentum has shifted to for-profit plans, but don’t count out not-for-profits, particularly these three innovative and–for many enrollees–beloved HMOs. They aren’t resting on their laurels.
‘Needed: A New “Bill of Rights” For Mental Health Care Providers’ 54G
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.
Scott Weingarten, M.D., Talks About Clinical Systems to Improve Care 59
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.
Diary of the Birth Of an HMO 69
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.
Use a ‘SWAT’ Team To Collect Old Receivables 81
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.
Projecting a Leaner Managed Medicare 83
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.
DEPARTMENTS
- Editor’s Memo 6
News and Commentary 16
Washington Initiatives 18
State Initiatives 20
Employer Update 28
Compensation Monitor 35
Legal Forum 87
Ethics 89
Managed Care Outlook 92
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.