Vol. 8, No. 12 December 1999

Three Health Care Startups Reach for More Than Survival

They are young, but they are already big. Each is attempting to define a whole new way of doing things. If they fail, it won’t be for lack of vision or courage. Of course, luck’s another matter.

Cover Story

The Balancing Act Called DTC Advertising

Patients lack patience: They want what they want when they want it. That truism about human nature can keep HMO executives up at night when the thing consumers often want is the most expensive of off-formulary medications. How to cope.

Q&A: Michael L. Millenson Makes Case for Excellence

This health care consultant says there’s no reason why great care can’t be delivered at a reasonable cost. HMOs and physicians should welcome accountability as a key to better outcomes.

Mangled, Mauled in Merger? There’s Life After Bankruptcy

Yes, worry if the numbers don’t add up. Fight to survive in this tough health care marketplace. If, willy-nilly, the worst should happen — don’t despair, say two Chapter 11 lawyers.

Industry Insiders React (Yawn) To United’s Bow Toward Doctors

United Healthcare’s announcement that physicians’ medical decisions will not be overruled by accountants caused an uproar in the press. The reaction from HMOs is muted.

Special Supplement

Reimbursement Considerations In Treating Hypercholesterolemia [PDF]

The economics of drug therapy and implications for medical groups and health plans are considered in a roundtable discussion.

DEPARTMENTS

Editor’s Memo
DTC: A silver lining.

News and Commentary
Premiums Climb 8 Percent For Second Consecutive Year
Medicare Spending Dips For First Time
As PacifiCare Retrenches, Is Sale Next?
Handful of PPOs Agree To Take Part In NCQA Review
Give Us Defined Contribution, Say Workers in Survey
Fallout from HMOs’ Medicare pullout [chart]
Weiss Ratings: 10 HMOs Weak, Nearing Failure
Headlines On Deadline…

Washington Watch
Federal authorities are concerned that Medicaid is vulnerable to Y2K.

State Initiatives
Rates of the uninsured grow more rapidly in Southwest.

Compensation Monitor
Capitation paying less to doctors. [chart]

Ethics
Some tough new ethical problems ready to invade the industry.

Legal Forum
The OIG approves safe harbors for ambulatory surgery centers.

Managed Care Outlook
Average health plan left with only 8 percent for administration.

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