Why did Coventry's medical loss ratio increase?
Because they allowed workers comp and national accounts to dictate provider contracting strategies, ... it even emphasize medical management, chronic care management, outcomes assessment, provider profiling, or any other form of 'managed care'. Coventry is expert at managing the balance between pricing [more...]
Date: 2009-02-11 16:24:07
Blog posts
(296) |
Videos
(220)
Concierge Medicine Garners Popularity In Lone Star State
Austin doctor Sid Robin practices medicine the way he believes most primary care physicians would like to — getting paid up front, ... an increasing number of primary care doctors in Texas who have eschewed the managed care system to run ... replacing the managed care model, Family Doctor it is increasingly appealing to doctors. It allows them [more...]
Date: 2009-02-28 19:52:04
Health care costs reaching the boiling point
While finishing up a relaxing vacation in Los Angeles last week I saw Costs for individual health plans soar in the USA Today outside my hotel room ... getting squeezed ever tighter.In the late 90s, employees rebelled against managed care’s effective ... at managed care as their friend, and to demand plans that put a damper on utilization as well as [more...]
Date: 2009-02-24 02:58:17
Using a Professional Care Manager
Services from care managers should be something that every family takes advantage of, but in reality very few families use them. Care managers could go a long ways towards helping the family find better and more efficient ways of providing care for a loved one. The concept is simple [more...]
Date: 2008-10-15 22:16:40
The "Scorpions in a Bottle" Shook Hands - A Secret Deal Between a Health Care System and a Managed Care Organization
The Boston Globe just published a series of investigative reports about a case that illustrates what went wrong with last 20 years' paradigm of health care reform. Remember how business-like management and competition were going to control health care costs (while improving quality and access)?The reports focus on how Partners Healthcare [more...]
Date: 2009-01-05 21:12:00
Misleading managed care headlines
Last week a study hit the wires indicating that managed care plans did not have better outcomes for carotid endarterectomies (CEs), a surgical procedure ostensibly intended to reduce the risk of stroke. Here's the headline from UPI - "No managed care link for stroke-prevention" [more...]
Date: 2009-01-06 12:10:57
Reasons to go the DMAA Forum 08
The Annual DMAA confab is less than a week away. In addition to hearing the latest in population management, ... on health services research, disease management and managed care insurance."This is without question ... of organizations delivering solutions in collaboration with primary care practices. Panelists [more...]
Date: 2008-11-18 02:22:00
e-Doubts from the Disease Management Care Blog about Health Information Technology: Caution Mr. Obama
The Disease Management Care Blog couldn't help but notice David Kibbe and Brian Klepper’s ‘open letter’ to President-Elect Obama on the topic of ... . e-referrals should work fine in health insurance settings in which patients are assigned and have a primary ... health IT spending. It was awfully hard to avoid after being posted simultaneously on multiple [more...]
Date: 2008-12-17 02:07:00
"Curtail Medicare"
A friend sent the following news excerpt, "President Obama today unveiled a multi-trillion-dollar budget ... (1) force private insurers who sell Medicare managed-care plans to undergo a competitive bidding process ... managed-care plans to undergo a competitive bidding process" The Bush administration privatized [more...]
Date: 2009-02-27 02:04:00
Predictions for Comp managed care in 2009
Much against my better judgment, here are my predictions - in no particular order - for the work comp managed care world in 2009. 1 ... in many secondary and tertiary markets, some decent business in Medicare and other governmental programs ... more comfortable. As to what happens with Coventry's comp business, more on that when the time comes. 2. Aetn [more...]
Date: 2009-01-02 01:12:18
New Day: Managed care grabs new opportunities under Obama
The Obama era holds potential business opportunities Incoming Congressional leaders and the President-elect have launched a major campaign to ... and CEO of Hudson Health Plan, a managed-care Medicaid provider in New York. For insurers ... in the growing individual market. Increased coverage will boost access to care, reduce cost-shifting [more...]
Date: 2009-02-11 13:00:00
Health Insurance Plans Offered by Employers - Network Based Managed Care Programs (pfblogs.org)
Thanks to a reader named Matt, a health actuary, who shared his feedback on the health insurance for a new job post and takes a look at the ... network-based managed care programs. PPO: What you described here is actually more like a traditional indemnity plan (which are rare these days). A Preferred Provider Organization actually does have ... ... [more...]
Date: 2008-09-17 11:26:20
Fed?s Medicare Proposal Sends Managed Care Tumbling
The second- and third-biggest decliners on the New York Stock Exchange today are two managed care firms: $605.8 million HealthSpring (HS) is down $4 ... from private Medicare coverage. The last time HHS “dealt a crushing blow to Medicare Advantage capitation ... . The cause is the department of Health and Human Services’ release Friday evening of proposed [more...]
Date: 2009-02-23 19:26:55
What, The RUC? - A Prominent Health Care Policy Blog Leaves Some Important Things Out
A new US President, health care costs that continue to rise despite declining access and questionable quality, ... integrated health systems or by managed care companies procuring health care from different systems ... even during an unprecedented global economic crisis all have made health care reform a hot topic [more...]
Date: 2009-01-09 16:41:00
Obama’s Budget and Healthcare Mix Like Oil and Water
Healthcare stocks took it on the chin last week following Obama’s budget submission ... , managed care providers, medical technology companies and insurance firms all fell in lock step ... Investor that I write for, we have two long positions (A diagnostic company as well as a managed care [more...]
Date: 2009-03-04 13:23:57
Safety
----------------------- Nurses Physicians For the information of: Physicians Nurses Patient Care Managers Site Managers Clinical Nurse Educators Cinical Support Health Professionals Equipment ( Medication ( Professional Practice ( Technology ( Update ( Safe [more...]
Date: 2009-03-06 23:24:50
Politico: The fight for universal health care
Richard Kirsch, national campaign manager for Health Care for America Now, takes nothing for granted ... includes a $634 billion reserve fund to overhaul the nation’s health care system, Kirsch was running a two-day training session for his group’s 150 field organizers, looking ahead to a nationwide battle over [more...]
Date: 2009-03-03 23:52:36
AHRQ Posts a Tool Kit for Yesterday's Care Advances
The Disease Management Care Blog found this on-line AHRQ "Tool Kit" ... for service versus capitation) and the ability to bill for ancillary services. It focuses on how ... ) or to what Medicare will use in its upcoming Medical Home Demo. Coming out with a similar document [more...]
Date: 2008-09-26 08:51:00
Personal Finance Roundup
By freemoneyfinance, 8:00 AM on Thu Feb 19 2009, 729 views New lessons from the crash ... on the big picture and show you exactly where your money goes."5 Ways to Cut Elder-Care Costs Smart Money "To help you better manage the costs of caring for an elderly loved one, follow these tips [more...]
Date: 2009-02-19 13:00:00
Obama To Raise Taxes On Wealthy!
The Wall Street Journal is reporting that President Obama will propose $634 billion in tax increases on upper-income taxpayers and cuts to government ... to get health coverage to all Americans, but also at curbing health-care spending overall. The cuts would affect a range of interests, including managed care companies, prescription drug manufacturers [more...]
Date: 2009-02-25 21:53:00
The Health Care Crisis, Part I
Dr. Hui explains what managed care organizations are, and their…Tags: care, crisis, economic, economy, health, HMO, hospitals, insurance, MCO, medical, medicine, pinky, show [more...]
Date: 2009-03-06 16:24:50
lounge weekend
After an active week at work and Stefan being off, we went to a very nice relaxed dinner party at our friends house. Great fajitas! And dessert! ... managed good patient care but the ordering of supplies and routine administrative issues have fallen ... The walk home literally took less than 5 minutes. Yesterday we had plans to go out to Red Square [more...]
Date: 2009-03-01 06:33:19
The Difference Between Indemnity And Managed Care
by Jordan FeRoss There are two basic types of health insurance coverage in Texas ... a concern for many. HMO’s ( Health Maintenance Organizations), as managed care health insurance [more...]
Date: 2009-02-14 07:03:36
Five small indicators of trends in aging in place technology
Times are bad. Agreed. But here are a few items that are a reminder that marketers will market and enterpreneurs will seize an opportunity when they ... to study the health benefits. Geriatric care management training includes use of technology. How ... out of the Berkeley school of health are developing a business plan around ways to keep seniors [more...]
Date: 2009-03-06 14:20:55
Managed Care IBNR Claims
Tax Savings StrategiesBy Ana VassalloManaged Care Organizations (MCOs) that accept capitated risk contracts face a potentially significant tax burden for Incurred ... based on studies of prior lags in claim submission records IBNR reserves. In capitated contracts [more...]
Date: 2009-02-02 00:03:23
Repackaging Bad Ideas in Health Care
I fail to see why Ezra Klein is so excited about a proposal by Bobby Jindal to move Medicaid recipients in Louisiana into managed care plans ... systems. There is a tremendous difference between Medicare for All and Medicaid ... care. This HMO model was tried (and to some degree still exists) for employer-paid health care [more...]
Date: 2008-11-15 09:06:34
Kathleen Sebelius to HHS
To no one’s great shock, Barack Obama has selected Kathleen Sebelius as his third choice for Secretary of Health and Human Services ... program.But with President Obama about to begin a drive to expand health coverage, an issue on which ... . She had much more experience at health-care management than Tom Daschle, without the baggage [more...]
Date: 2009-02-19 13:06:02
Patient Flow Solutions are on the Horizon
In my January 8th post, I discussed the expected renewed focus on e-health records as the venture community invests in this field ... Corporation, well-known provider of software systems designed to help health care systems proactively manage ... savings.With all eyes focused on healthcare costs in the next few years, look for more competitors [more...]
Date: 2009-01-15 09:21:22
Netherland Jobs: PhD positions healthcare gov Erasmus University
The institute of Health care Policy and Management offers the position of / *Ph.D ... and management positions in healthcare, which serve 750 students. In addition, research is being done on three major research themes: ‘market organising and system setup’, ‘quality and effectiveness [more...]
Date: 2009-03-05 05:26:42
Medical Homes and care coordination are tested
Older Americans who, understandably, have more chronic conditions of aging, ... coordination of care” and disease management programs provided by Medicare and other health plans (sometimes ... the quality of care and reduces Medicare expenditures, the Balanced Budget Act of 1997 mandated [more...]
Date: 2009-02-16 03:24:00
The (short term) future of workers comp managed care
The comp conference ended (for me) last Thursday; the passage of time allows for the individual impressions to meld into an overall picture of the ... , Medicare increases reimbursement for E&M codes (cognitive services), then the clinic business could well get a major boost. Almost all WC fee schedules are based on Medicare, so any change [more...]
Date: 2008-11-24 15:43:45
Health Insurance
Description This book provides a thorough overview of health insurance in the United States, with an emphasis on private insurance . Topics covered include: The historical development of U.S. health insurance and the theory of demand for insurance, Issues of adverse selection and moral hazard, How managed care affects [more...]
Date: 2009-02-18 00:05:22
Chris DeFoe - Founder, DeFoe Associates
Christopher DeFoe brings 15 years of HR systems experience to his role as CEO and one of the principals of DeFoe Associates ... has been employed at major organizations (Fortune 500, health care, public sector) across the globe ... Group) managing their Hiring Management Systems practice, and prior to that he managed [more...]
Date: 2009-02-25 14:26:02
The ten skilled nursing facilities in New Mexico
Skilled Healthcare Group, Inc. (NYSE: SKH) today announced its unaudited consolidated financial operating results for the three- and six-month ... is defined as the number of Medicare and non-Medicaid managed care patient days at the company’s skilled ... Healthcare’s ancillary services segment, comprising rehabilitation therapy and hospice services [more...]
Date: 2008-08-11 15:47:27
Health Insurance Plans Offered by Employers - Network Based Managed Care Programs
Thanks to a reader named Matt, a health actuary, who shared his feedback on the health insurance for a new job post and takes a look at the ... have a network, much like you describe under the HMO section. The insurance company contracts ... like this because there is less control over your utilization compared to a POS plan or HMO. POS: This type [more...]
Date: 2008-09-17 10:49:17
The Baucus Blueprint for a Call to Action for Healthcare Reform, Part 1
Readers of the Disease Management Care Blog will probably want to pay attention to that ‘Sleeper of the Senate,’ Max Baucus (D – Montana) ... by a prodigious number of peer-review references that is intended to guide an ‘investment’ intended ... ) to match insureds with insurers, temporarily lowers the Medicare eligibility age to 55 years [more...]
Date: 2008-11-13 15:34:00
Get Clean with Shaklee
Cleaning, in and of itself, is not high up on my list of “fun things to do,” and when you add in the smells and the chemicals, ... and weight management to skin care. When I received the Get Clean Starter Kit , I was honestly ... into every Shaklee bottle is designed to improve health, work without compromise, and be gentle [more...]
Date: 2009-03-05 17:37:08
Please explain a PPO
by Jeff Cline A Preferred Provider Organization (PPO) is a managed care product. It is health insurance available to consumers that have structured benefits and a professional ... the insurance company paid 100% of expenses. A PPO may also have set dollar amount for specified medical [more...]
Date: 2009-02-22 09:08:07
Who Really Gave Birth to Octuplet Mom?
It all got so ugly, so fast. Last Monday, octuplet mom Nadya Suleman was attempting to soften her media image with a carefully stage-managed Today ... that the disability benefits she collected for an old on-the-job back injury—more than $165,000 according to the AP— ... . Including medical expenses, the ultimate tax-payer bill, according to the paper, [more...]
Date: 2009-02-16 23:19:00
Eight Fallacies of Managed Care
A Startling iMBA Inc., Report on Small Medical Practices By Dr. David Edward Marcinko; MBA, CMP™ By Hope Rachel Hetico; RN, MHA, CMP™ By Ann Miller; RN, MHA Webster defines a visionary as: “one who is able to see into the future”. Unlike some pundits, prescience is not a quality we claim to possess [more...]
Date: 2008-12-08 00:15:02
Hold it: State wants to pre-approve bedpans for poor patients
The state of Missouri has two words for Medicaid patients who need to use a bedpan, commode chair or urinal: Ask first ... themselves now is subject to that famously despised technique of managed care called “pre ... bureaucrats. Pre-approval originally was designed to prevent people from using too much health care. There’ [more...]
Date: 2009-01-19 03:00:55
Governor’s Mental Health Proposal Would Cause Irreparable Harm to Clients and Communities
A broad coalition of mental health advocates Tuesday blasted Governor Schwarzenegger’s proposal to permanently reverse parts of the state’s landmark ... obligations for basic mental health services provided under the Medi-Cal Managed Care Consolidation ... of Proposition 63, permanently locking California into the inadequate mental health financing system [more...]
Date: 2009-01-30 14:14:46
Sebelius at HHS
Overhauling our health care system is going to take the will to fight entrenched special interests and lobbyists, ... from special interests. And before being elected governor, she served as Kansas Insurance Commissioner ... administration, where she handled health care budget issues and managed Medicare and Medicaid. Along [more...]
Date: 2009-03-02 18:11:00
Who Really Gave Birth to the Octuplet Mom?
It all got so ugly, so fast. Last Monday, octuplet mom Nadya Suleman was attempting to soften her media image with a carefully stage-managed Today ... benefits she collected for an old on-the-job back injury—more than $165,000 according to the AP— ... medical expenses, the ultimate tax-payer bill, according to the paper, could reach millions [more...]
Date: 2009-02-17 11:29:00
Unions Will Remake the Middle Class, Obama Says
(Robert Struckman writes for the Montana Change That Works campaign, which is a project of the Service Employee International Union .) ... a strong labor movement....And as we confront this crisis and work to provide health care to every ... and management contend must be level. 
 "I have a simple, basic belief," he said. "If a union [more...]
Date: 2009-03-06 22:52:55
50 Tips and Tools to Manage Your Own Medical Care
With Washington fighting over the state of average Americans’ health care rights and medical costs, ... terms like PPO, HMO, co-payments and more on this website. Health Insurance is Complicated… ... the rest of us have been left to our own devices to come up with creative ways to find insurance [more...]
Date: 2008-09-24 14:26:13
Managing in the Next Society: Peter F. Drucker
Editorial Reviews From Booklist Touted as the longtime business analyst’s last book, ... specializing in industries such as technology, health care, and management. Drucker provides insight ... are not arranged in chronological order, Drucker covers trends, emerging industries, and management [more...]
Date: 2009-03-05 05:04:13
Coordinated care does not equal Medicare savings
Filed under: Health One often expressed suggestion for controlling public health care costs is for Medicare to adopt a strategy of the private ... such as coronary disease and diabetes,who were racking up Medicare bills of $1,535, on average,per month, three times that of the average Medicare recipient. For the test, the managed care staff [more...]
Date: 2009-02-12 13:00:30
Reaction to President Obama's speech
As always, he delivers his speeches well. He sounded forceful and determined and on top of things ... waste, fraud, and abuse while taxing only the very wealthy and be able to do all the things that he's taken on such as bailing out the economy, starting us on the way to a health care policy managed by the [more...]
Date: 2009-02-25 11:22:00
The Baucus Blueprint for a Call to Action for Healthcare Reform, Part 2
How about chronic illness? Even if the Senator Baucus' Call to Action never sees the light of day, ... as well in recent Medicare demonstrations. While these approaches should not be jettisoned without ... Medicare should make direct payments to vendors outside of a comprehensive care management model [more...]
Date: 2008-11-14 04:08:00
1 -
50
of
296
Posts
Page:
First
| <
Preceding
|
Next
>
0
|
1
|
2
