When the Pacific Business Group on Health contracts with health plans, it places 2 percent of the premium at risk to promote cooperation between plans and providers. If a plan meets specified targets for “partnering,” as PBGH calls it, the plan keeps the portion of the premium at risk. How well do plans meet that goal? According to a PBGH survey of medical groups and independent practice associations in four states, HMOs’ relationships with physicians are improving, but there is still a need for closer collaboration.
Physicians were asked to rate the following health plans: In Arizona, Aetna, Blue Cross Blue Shield, Cigna Network Model, HealthPartners, Humana, Intergroup, PacifiCare and United HealthCare; in California, Aetna, Blue Cross CaliforniaCare, Blue Shield, Care America, Cigna, FHP, Foundation, Health Net, PacifiCare and Prudential; in Oregon, HMO Oregon, Providence Good Health Plan, SelectCare, QualMed and PacifiCare; in Washington, Health Plus, First Choice, Providence Good Health Plan, Group Health Northwest, QualMed and PacifiCare. Kaiser Permanente, with its single physician group, was not part of the survey.
SOURCE: PACIFIC BUSINESS GROUP ON HEALTH, SAN FRANCISCO, 1998
Our most popular topics on Managedcaremag.com
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.