The Big Squeeze

Managed care companies’ earnings have dropped in the last year. Can premium hikes help restore bottom-line luster?

Helping Hands for HEDIS

Figuring out HEDIS’s complicated reporting specifications can be quite a task. Entrepreneurs are willing to help.

DM Program Parts for Sale (Some Assembly Required)

Many health plans have answered the build-or-buy question concerning disease management by selecting a third path.

Does Mail-Order Pharmacy Really Deliver the Goods?

Mail-order pharmacy has proven cost-effective, but detractors say it just rides on the back of community pharmacies.

A Conversation With Margaret T. Stanley

The health benefits administrator for CalPERS discusses Kaiser Permanente’s rates and other purchasers’ concerns.

This IPA’s Slide Toward Ruin Could Have Been Prevented

A marketing consultant explains how misplaced trust and the lack of a pre-existing condition clause nearly proved fatal.


Editor’s Memo
Price Hikes May Ease Pressure–Temporarily

News and Commentary
Viagra Takes Market by Storm; Who Pays is Another Matter
Three Groups Say They’ll Coordinate Accreditations
Aetna Extends Olive Branch To Texas Doctors
Sachs Names Health Plans To ‘Honor Roll’
Blue Days For Blues In Pennsylvania
Would You Believe A Premium Hike Of 30 Percent?
Why people select health plans [chart]
Headlines On Deadline…

Washington Initiatives
‘New PARCA’ Doesn’t Placate Critics; Passage Prospects Going Down Tube
Rules Finally Out For PSO Solvency; Expect Slow Start
Plan To Streamline Claims Processing Gets Tepid Review
Are DRGs Coming To Psychiatric Hospital Near You?
HCFA to Plans: Don’t Request Ethnicity Info
Take as Needed…

State Initiatives
Judge to HMO: Stop Fining Doctors Who Exceed Pharmacy Budgets
Missouri Blues Agree To Transfer Millions to Charity
Medical Costs Definitions Differ In Minn. Dispute
Several HMOs Stung in N.Y. Test Of Consumer Law
Mental Health Coverage Parity In Delaware
Bill Restructures Calif. Oversight Of Managed Care

Employer Update
New Service Links Distant HMOs In Covering Far-Flung Employees

Compensation Monitor
AMA: Doctors’ income still rising

Is Sex Medically Necessary? Who Should Pay for Viagra?

Legal Forum
Stark II: Division of Profits Comes Under Closer Scrutiny

Managed Care Outlook
Managed medical care growth rubs off on dentistry

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