Vol. 8, No. 6 June 1999


PPOs: A Better Brand of Managed Care?

For the first time, HMOs are losing market share to PPOs. But costs and accountability will challenge PPOs’ staying power.

Diverse Populations Offer Plans Chance To Do Good — and Well

Health plans can do well by doing good, if they know how to create programs that best serve the needs of minority members.

Antifraud Push Means Plans Need To Focus on Compliance

Legislators and enforcement agencies are seeking to put the burden of preventing and detecting fraud and abuse on plans.

The Inevitability of E-commerce

When it’s perfected, it should mean lowered costs and fewer hassles. But one expert advises against waiting for perfection.

A Conversation With Donald Berwick, M.D.

The low-key head of the Institute for Healthcare Improvement calls for nothing short of a revolution in the business of medicine.

DM’s Motivation Factor Can Skew Study Results

Too often, the studies that disease management vendors use to sell their programs are seriously flawed. Here’s what to look for.


Editor’s Memo
Managed Care’s Makeover: Can PPOs Handle the Task?

State Initiatives
As All-Products Clauses Spread, Physicians Make Tough Choices

News and Commentary
Increased Attention Given Growing Rolls of Uninsured
Texas HMOs Told To Get Profitable Or Risk Closure
CalPERS Accepts Average Rate Hike Of Nearly 10%
Kaiser, Oxford See Quarterly Gains; 1st Since 1997
TennCare’s Chief Says Fraud Threatens To Sink Program
Headlines on Deadline…
By the Numbers
Spending drops on behavioral health benefits, but the decline in share of total coverage halts [charts]
Women’s health: Not enough strides [charts]

Washington Watch
GAO Report on Medicare Pullout Outrages Many in HMO Industry

Compensation Monitor [charts]
Study shatters big myth about primary care compensation

Is Taking a Class in Ethics Cruel, Unusual Punishment?

Legal Forum
Contract Talks Are Like Dating: Ask Those Important Questions

Managed Care Outlook [charts]
When medical necessity is disputed

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