April 1996

The Compliance Challenge in Treating Helicobacter Pylori

It’s all well and good to know that H. pylori causes peptic ulcer disease. But putting this knowledge to work curing ulcers — and saving money — means making sure the patient actually takes the pills.
Managed care owes much of its financial success to the “gatekeeper” system. But some health plans are tinkering with that model in hopes of providing care even more cost-effectively.

Anne Bilodeau

The “gatekeeper” model for controlling health care utilization is inherently flawed, argues this physician, who says substituting a more flexible system could save money as well as improving health care.

Five Lawyers Recall: ‘The Craziest HMO Contract Clause I’ve Seen’

In drawing up contracts, HMOs aren’t shy about asking for terms favorable to themselves. Here, five health care attorneys discuss the most outrageous HMO demands they’ve encountered. Watch out for clauses like these.

Deborah Epstein

Friends and foes of “any-willing-provider” legislation don’t line up as predictably as they once did. And even in the states that have enacted such laws applying to physicians, AWP is turning out to be a less ferocious beast than its backers had hoped.

Departments

EMPLOYER UPDATE

Preventive Medicine Rides the Rails on the Far-flung Union Pacific

WASHINGTON INITIATIVES

Governors’ Medicaid Plan Draws Powerful Enemies in a Hurry

COMPENSATION MONITOR

Managed care and revenue in single-specialty groups

LEGAL FORUM

When Structuring Contracts, Don’t Forget About State Laws

MANAGED CARE OUTLOOK

IPA models predominate among newer HMOs


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