COVER STORY

Risk Adjustment: Immature System Heads for Big Time

Health care stakeholders will be watching when HCFA installs a risk-adjustment methodology for Medicare+Choice. Could such a system work in the private sector? Who would gain? Lose?

A New Model For Managing Care

At least in California, HMOs are becoming superfluous, says one physician who sees them being replaced by physician-owned and -controlled medical management companies.

Service Often Too Slow When HMOs Use ‘McLabs’

Health plans often contract with large regional laboratories to save money, but microbiologists and some physicians see quality eroding in several ways. Has consolidation gone too far?

Thinking Globally, Acting Locally

Managed care goes international. Is the world just another new market, a business opportunity, for stateside HMOs — or is this also a golden opportunity to learn from overseas experience?

DEPARTMENTS

Editor’s Memo

News and Commentary
Health Spending Lowest in 40 Years, But HCFA Estimates Trend Won’t Last
AAHP’s Analysis Of Election Day: We Told You So
Doctors Heading To the Country To Escape HMOs?
Medicare Payment Formula Triggers Specialists’ Suit
Aetna Rewrites Doctor Contracts; AMA Not Swayed
Where health expenditures have been, and where they are likely to go
Headlines on deadline

Washington Insight

State Initiatives
Suicide Prompts First Challenge of HMO Liability Law in Texas
Court Allows Suits Against Pa. HMOs Over Care Issues
Mass. Medicare Plans Will Limit Drug Benefits
New Jersey Sues Management Co., Seeks HMO’s Reins
Colorado Seeks Proof of Quality From Health Plans
Citing Losses, Florida Closes Troubled Plan

Compensation Monitor

Ethics

Legal Forum

Managed Care Outlook

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