Vol. 6, No. 9 September 1997

A Special Section: Doctors Taking Back the Power?

Will Physicians Reclaim Control of Medical Care?  20

A couple of years ago, experts began saying physicians would reclaim some of the clout lost to HMOs in early managed care. We focus on four innovative physician groups to see if the prediction is coming true.

They Made The Right Choice When The Money Ran Low  30

Fairfax, Va.: Fairfax Family Practice Centers

Making ‘HMO’ a Synonym For ‘Insurance Company’  35

St. Paul, Minn.: Family Health Services Minnesota

Greater Freedom Through Winning HMOs’ Trust  41

San Francisco, Calif.: Brown & Toland Medical Group

Life Can Be Simpler With a Cash-Rich Partner  50

St. Petersburg, Fla.: St. Petersburg/Suncoast Medical Group

Physicians’ Big Peeve: HMO ‘Hypocrisy’  55

If doctors do launch a “second revolution” in health care, it may be because of these things that bother them about managed care.


A Day Spent Learning To Satisfy Patients   57

For both physicians and health plans these days, it’s imperative to make sure patients are satisfied “customers.” But just how is that done? Our reporter attended a workshop in Wisconsin to find out.

Are Your HMO’s Documents Readable?  60A

Why can’t patients understand managed care information? Too often, health plans’ printed materials go way over their members’ heads.

A Reporter Explains His ‘HMO Horror Stories’  61

If you’ve ever grumbled about how the press plays up one tragedy while ignoring millions of successes, you won’t enjoy reading this essay by a Pulitzer Prize winner. But it offers a public relations lesson.

An Interview With David Nash, M.D., M.B.A.  65

The director of health policy and clinical outcomes at Thomas Jefferson University sees a day when costs of care will be predictable. That will mean changes for both physicians and HMO administrators.

‘PSOs’: Managed Care’s Next Generation?  83

Backers hope that provider-sponsored organizations will offer strong competition to conventional Medicare and Medicaid HMOs. Opponents say PSOs have been given an inappropriate advantage.

Ten Pointers For Tracking HEDIS Data  90

Organizations such as NCQA are grading managed care plans and making the results public. Health plans, in turn, are evaluating physicians. Here are some practical suggestions for making the grade.

Guest Article

Innovation + Incentives + HEDIS = High Immunization Rates  99

The national goal is to immunize 90 percent of children under two by 2000. Innovative techniques help health plans aim for that target.


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