Vol. 7, No. 7 July 1998

COVER STORY

Missing the Mark

Health plans that miss the mark are out there, but trying to identify them is akin to the plight of the X-Files agents who find circular traps at every turn. This package also examines: * Characteristics of plans that miss the mark * What to do if your health plan comes up short * How employers feel about poorly performing plans

Bad Karma in Colorado

A physician who recently moved to Boulder, Colo., finds it to be a hotbed of out-of-this-world “treatments.”

Medicare and Managed Care: Perfect Match?

Experts say wedding the Medicare program to the managed care industry could turn out to be a very happy union indeed.

Genetic Testing: Do Plans Know Too Much?

Laws are needed to prevent discrimination on the basis of genetic information. Drafting such legislation won’t be easy.

A Conversation With David Lansky

FACCT’s president wants patients to shake off the shackles of paternalism and make health care decisions for themselves.

DEPARTMENTS

Editor’s Memo

News and Commentary
AAHP Members Add Requirements To Patient Policy
Aetna To Offer New Electronic Claims System
As AMA Picks Its ’99 President, ’98 Leader Picks Up Benefits Whip
Surprise! Little difference between HMO, indemnity lengths of stay [charts]
Members want choice [charts]
More HMOs Decide Viagra Coverage; Global Frenzy Is On
United HealthCare And Humana Plan $5.5 Billion Merger

Washington Initiatives
Coalition of Consumer Organizations Says ‘HealthMarts’ Would Hurt Workers
HHS Report: HCFA Is Not Keeping Up On Managed Care
HHS To Provide Guidance About Emergency Care
Warning Prompts Physician Concern On PPM Payments
After Viagra Fuss, Women’s Groups Say ‘Help Us, Too’
Take as Needed…

Compensation Monitor
Health care systems turn to bonus pay

State Initiatives
Kaiser-CalPERS Deal: Rate up, Oversight Too
New York Fines HMOs Failing Test Of Consumer Law
Rhode Island Fines United Over Denials
HMO Complaints Posted Online @ Texas Web Site
When It Comes to Viagra, State Medicaid Programs Vary
No Go: Deals Off For Blues Plans In Mass., Texas

Employer Update
Employers Tell Health Plans ‘Not So Fast’ on Premium Hikes

Ethics
Understand Guiding Principles When Mixing Business, Medicine

Legal Forum
Remuneration Arrangements Important Part of Stark II Regulations

Managed Care Outlook
What HMOs, insurers review when predicting health care costs


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