Medicaid Reform: Theory of program was flawed Sep 15, 2008
The state of Florida buckled, in the midst of our budget crisis, to limit the cut to 3 percent so the HMOs could have their profits. Profits that, instead of going to private HMOs, could have been used to ease some of the other major budget cuts in the Medicaid delivery system ... This financial break to HMOs comes after the Agency for Health Care Administration quietly removed the requirement that 80 percent of the HMO budgets actually go to direct services, paving the way for HMOs to make more... (Florida Times-Union)
Let the debate on universal health care begin Sep 13, 2008
" Most customers of HMOs don't. She implies that people with unhealthy lifestyles pay extra for health care; they don't. She admits that insurance companies unduly influence medical decisions, but assumes without evidence that a government program would do worse. She implies that there now is real competition "to keep the players in check and offer us options. " This shows a misunderstanding of health care itself. People don't shop around for the cheapest doctor, medicine or procedure. Neither... (Albany Times Union)
Health care rates still rising as employers seek alternatives Sep 10, 2008
The program negotiated a basic HMO plan increase of 6 ... The cost of HMOs versus less-restrictive PPO plans has narrowed in recent years, Lansky said, posing challenges and opportunities for employers who want to offer a variety of plans of comparable cost and quality. (Sacramento Business Journal, CA)
Editor's mailbag (Sept. 6) Sep 9, 2008
EH wrote on Sep 6, 2008 10:53 AM:" John you mention that Senator McCain will make change in Washington.One of the changes he will work on is to privatize the VA and turn it into an HMO. The VA has functioned well since WWII. The insurance companies run HMOs.When Senator McCain spoke at Denver 7/08/08 the first question from the audience was from a Vietnam veteran, who challenged McCains voting record of supporting health care for veterans. You do not have a perfect voting record with [Disabled... (Albany Democrat-Herald, OR)
HMOs to feel pinch as cuts hit Medicaid Sep 9, 2008
To help slash spending on those health benefits by a required 5 percent, the Georgia Department of Community Health (DCH) wants to assess an annual 3 percent tax on commercial health maintenance organizations (HMOs) ... The proposed tax, or Medicaid managed care provider fee, will result in higher premiums for the state s commercially insured population, said Tom Davis, CEO of of Georgia Inc. The majority of Coventry s 140,000 Georgia customers are in HMO plans ... While the tax might hammer HMO... (Atlanta Business Chronicle, GA)
Post a comment » Sep 9, 2008
x-Navy wrote on Nov 14, 2007 9:55 PM:" I have a few questions that I have yet to make sense out of. Since when does not supporting the war mean that you're not supporting your troops? How does supporting the war, and voting to keep soldiers and sailors on the danger line so they can return to an inadequate HMO health care regulated system that will not provide proper treatment equate to supporting the troops? Where does the funding come from, who will be owed, and what does that mean for future... (Canton Daily Ledger, IL)
The great 2008 'Paper Debate' Sep 9, 2008
propose we expand Badgercare and create a State of Wisconsin HMO.. We need to bring good paying jobs to this part of the state. (Menomonie Dunn County News, WI)
Centene names Husa to head Wisconsin subsidiary Sep 9, 2008
MHS (HMO) in Milwaukee to start paying physicians for meeting certain health improvement goals for patients enrolled in the HMO.. Reader Comments. (Milwaukee Business Journal, WI)
Milwaukee health plan starts paying doctors a bonus Sep 5, 2008
one of the largest administrators of the state s and Medicaid SSI plans, which provide health benefits to low-income state residents, is the first health maintenance organization (HMO) in Milwaukee to start paying physicians for meeting certain health improvement goals for patients enrolled in the HMO.. Representatives of the Milwaukee-based HMO hope that by paying for performance, the HMO will save money by keeping patients who are eligible for Medicaid healthy and out of the hospital. (Milwaukee Business Journal, WI)
Nurse-run health centers seeking higher reimbursements Sep 2, 2008
In this region, Medicaid HMO plans pay nurse-managed health centers a pre-established rate of $12 per patient per month. The cost for one visit averaged about $120. (Philadelphia Business Journal, PA)
Stay Healthy, Live Longer, Spend Wi... Aug 30, 2008
Dr. Liu explains what a Health Savings Account is, how to know if you qualify, fee for service programs (POS) and Health Maintenance Organization (HMO) plans. Even the healthiest person could become sick or involved in an accident so some insurance is better than none in an emergency. (Suite101.com)
Advertiser, unions to dump HMSA for Summerlin Aug 30, 2008
Coverage by , Hawaii s largest HMO, will continue to be offered, but the union said workers who choose to keep Kaiser will pay a substantially higher premium that will be based on the cost difference between Summerlin and Kaiser rates. " The unions say the switch will save the newspaper $164,000 a year. If workers approve the deal at a meeting Sept. 14, the unions will then move forward on other contractual issues, including pay. "I'm pleased we've reached this juncture and I agree that we have... (Pacific Business News, HI)
3% raises recommended for drivers Aug 30, 2008
Those enrolled in an HMO would be charged a $20 co-pay for doctor visits. Prescription co-pays also would be increased for everyone to up to $45. (Pittsburgh Post-Gazette, PA)
Health insurerto buy HMO Aug 29, 2008
Serving Volusia and Flagler counties, FHCP is the oldest federally qualified HMO in Florida, and the second oldest federally qualified HMO in continuous existence in the United States ... Health insurer to buy HMO ... Halifax Health's board unanimously approved the HMO's sale to BlueCross BlueShield of Florida on Thursday. (Daytona Beach News Journal)
Medicaid program losing providers Aug 29, 2008
The pilot was supposed to provide choices for Medicaid recipients, including different HMOs. If WellCare and United leave, only one small HMO will remain ... Kokol said Thursday there will be more than one HMO option in Duval County. (Florida Times-Union)
HMO to pay $41M for shorting NJ patients Aug 27, 2008
The HMO was once know as First Option Health Plan of New Jersey and Physicians Health Services of New Jersey. Submit your comment now. (The Trentonian, NJ)
Democratic National Convention Podium Schedule Monday, August 25, 2008 - One Nation Aug 25, 2008
uffs Health Plan (HMO) and grandson of FDR The Honorable Alexis Herman Co Chair Credentials Committee Former US Secretary of Labor Introduction of and Report by the Rules Committee The Honorable Howard Dean Chair, Democratic National Committee Sunita Leeds Co-Chair Rules Committee Chair of the DNC Indo-American Leadership Council The Honorable Mary Rose Oakar Co-Chair Rules Committee Former Member of the US Congress, Ohio, President of the American-Arab Anti Discrimination Committee The... (PR Newswire)
HMOs post higher profits, survey says Aug 23, 2008
Minnesota HMOs were more profitable in 2007 compared to the prior year, as higher premium costs helped offset declining enrollment, according to a report released Friday. HMO enrollment in the state dropped by 27,000 to 409,000 lives in 2007 ... However, HMOs combined profits totaled $119. (Twin Cities Business Journal, MN)
4 Ways to Save on Your Medical Bills Aug 22, 2008
When shopping for a health plan, is an HMO or a PPO better for you and your family. The list of supplies you need to make your own first aid kit. (U.S. News & World Report)
New Survey Shows Consumer-Driven Health Plans Continue To Grow Aug 19, 2008
7%) of employees enrolled, health maintenance organization (HMO) participation continues to slip, and now represents just 21 ... "Fee For Service and Exclusive Provider Organizations now virtually disappeared from the market, and HMOs are losing ground as employers seek to help contain the rising cost of health care and insurance premiums." In fact, while average premiums increased by 7. (PR Newswire)
Health benefits' cost rises Aug 15, 2008
Kaiser Permanente s HMO option for state employees will be phased out after 2009. Kaiser also is appealing the contract award. (Atlanta Journal-Constitution)
22% of Americans surveyed cut visits to doctor Aug 13, 2008
People covered by health maintenance organizations should contact the state Department of Managed Health Care's HMO Help Center at (888) 466-2219. The department's Web site is. (San Francisco Chronicle -- Business)
Health benefits inspire a rush to the altar, or to divorce court Aug 13, 2008
More than romance, the couple readily acknowledge, it is Huggins's Blue Cross/Blue Shield HMO policy that is driving their rush to the altar. In a country where insurance is out of reach for many, it is not uncommon for couples to marry, or even to divorce, at least partly so one spouse can obtain or maintain health coverage. (International Herald Tribune)
What's Up, Docs? Aug 13, 2008
Dave Duval might have died had he waited for either his HMO or a famous medical center to accurately diagnose his symptoms ... Health maintenance organizations (HMOs) in California must offer patients a second opinion, but it often must come from within the group's physician network ... After Duval's HMO spent months unsuccessfully trying to figure out what was causing his fever, night sweats and fatigue, he left the security of his insurance coverage and headed to Mayo Clinic for more extensive... (San Diego Union-Tribune)
American Heart Association Aug 12, 2008
Overall, that program utilized electronic data from some 15 HMOs in the HMO Research Network to look at the epidemiology, prevention and management of heart disease. Kaiser says that the chance for its patients of dying of a heart attack or stroke is 30 percent lower than it is for the general population, although the figure does not account for age and gender or socioeconomic differences between the populations. (East Bay Business Times, CA)
Hospitals could be stuck with the bill for mistakes Aug 11, 2008
Philadelphia s three Medicaid HMO plans are each taking steps toward following the s lead and not paying hospitals for the extra cost of care related to preventable medical errors ... Kenneth J. Braithwaite II, regional executive for the (DVHC), said local hospitals are pushing for the Medicaid HMO plans to adopt the same type of process and system being used by the state welfare department with regard to nonpayments for medical errors ... We re looking for [the HMOs ] policies to be clinically... (Philadelphia Business Journal, PA)
HEALTH BLOG: Are fruit drinks or soda worse for diabetics? Aug 11, 2008
Blue Cross/Blue Shield of Michigan created an HMO and a preferred provider organization, or PPO, that give employees discounts of up to 20% on copayments and employers and employees discounts on premiums if employees agree to "adopt a healthy lifestyle," complete a health-risk appraisal questionnaire and have their doctor verify every year that they're sticking with their healthy lifestyle plan. In 2007, nearly 40% of employers said they'd start paying employees for "health-enhancing behaviors"... (USA Today -- Life)
Psychiatrist Blumenthal Investigated In '02 Faces 2 Unrelated Complaints Aug 11, 2008
At the time that Blumenthal issued his 2002 report, Benet was the founder and medical director of Psych Management Inc., a firm that Anthem Blue Cross-Blue Shield hired to manage mental health care for Anthem's HMO.. Blumenthal found that Anthem's low payments to Psych Management, also known as PMI, combined with financial misdeeds by Benet, resulted in at least one patient, and probably others, being denied necessary mental health care. (FOX61, CT)
In Sickness And In Health Aug 10, 2008
Ask to see it in writing on your HMO's Web site or in your contract. And make sure you have an HMO number you can phone from overseas. (San Francisco Chronicle -- Travel)
Insurance Giant Leverages Technology to Enhance Offerings Aug 7, 2008
Each report includes information on: -- Competitive analysis -- Enrollment trends -- Company-wide financials -- HMO financials -- Consumer-driven products -- Medicare strategy -- Pharmacy -- Disease management About HealthLeaders-InterStudy HealthLeaders-InterStudy, a company of Decision Resources, Inc., is the authoritative source for managed care data and analysis. For more information, please visit. (PR Newswire)
State fines CDPHP $600G Aug 7, 2008
CDPHP was cited when some of its lines -- its HMO product and several policies run by subsidiary Universal Benefits Inc. -- failed to provide this information for 121,911 claims submitted between 2004 and 2006, the department said. The Albany-based health insurer has agreed to contact members to make sure they received the proper notices. (Albany Times Union)
Blue Cross, HMO Colorado fined by state Aug 6, 2008
HMO Colorado Inc. also was cited for not disclosing policies for obtaining emergency medical services. We have made it clear that our mission is to protect consumers and this market-conduct examination and resulting fine reflects our commitment, Morrison said in a statement. (Denver Business Journal, CO)
Metropolitan Health Q2 earnings up 17% Aug 6, 2008
In June, the West Palm Beach-based company (AMEX: MDF), announced plans to sell its HMO to Humana for an estimated $14 million. That deal is expected to close by Oct. 1. (South Florida Business Journal, FL)
JEFF EDELSTEIN COLUMN: Insurance isn't porn, so why the blimp? Aug 6, 2008
I went with the HMO plan, with $50/$70 co-pays, 50 percent out-of-pocket for prescription drugs, and a $5,000 maximum for inpatient hospitalization. In other words, a pretty lousy plan. (The Trentonian, NJ)
Humana's Results Lift Managed Care Sector Aug 5, 2008
The program allows Medicare beneficiaries to opt for an HMO instead of the government plan, which is appealing to recipients since Medicare HMOs have about 12 ... (See " ") But HMOs, or health maintenance organizations that hire medical professionals to provide specified services to prepaid subscribers, are criticized for making big money off of Medicare-based programs ... 0 billion in sales and half of its profits from Medicare HMOs. (Forbes -- Markets)
HEALTH BLOG: Read the latest child wellness tips Aug 5, 2008
Parenting and kids' health - Better Life - USATODAY.com. Unhappy about Happy Meals and the like. (USA Today -- Money)
Humana reports lower 2Q net income Aug 5, 2008
Humana has a large presence in Wisconsin with 435,000 total members, of whom 191,000 are self-funded, 98,000 are HMO or PPO customers and 126,000 are Medicare members. Reader Comments. (Milwaukee Business Journal, WI)
REGION: Hospital bond ballots start flowing in Aug 3, 2008
The people making the money are the HMO. Hospitals run on a 1 to 2 percent margin and they cannot afford to make this type of upgrade on operations alone. (North County Times)
Senior Subjects: Drugstore clinics may be coming soon Jul 30, 2008
By Rob Stuart-Vail/Columnist. Tue Jul 29, 2008, 08:11 PM EDT. (Lincoln Journal, MA)
Haggling Can Lower Health Costs, Some Say Jul 30, 2008
"If you have, say, Crohn's disease, you want to designate your primary care physician as your specialist in your HMO, if you can.". "Although employer coverage usually is still your best bet, you may do better on your own," wrote columnist Kimberly Lankford. (Click2Houston, TX)
Grabbing The HMO Rebound Jul 28, 2008
Shares of UnitedHealth Group (nyse: - - ) and those of its HMO comrades have declined significantly over last six months ... Competition among HMOs is intensifying; the weak economy is not helping, as employers are looking for ways to save money and downgrading their health care coverage ... HMOs have underestimated their medical costs. (Forbes)
Editor's notes: Not the only one blowing smoke Jul 27, 2008
If Fallon, my HMO, chooses to increase the amount I pay for coverage because I smoke, then I d be fine with that. But why should I be responsible for covering a larger portion than a nonsmoker of state subsidized health care because of my lifestyle decisions. (Kingston Mariner, MA)
Temple University Physicians not renewing contract with Keystone Mercy Jul 24, 2008
Those patients with new conditions will also have the option of switching their coverage to another Medicaid HMO plan to continue to see their Temple physician. Representatives of Keystone Mercy, the region's largest Medicaid HMO plan, were not immediately available for comment. (Philadelphia Business Journal, PA)
Hewitt Associates: Southeast to see highest HMO rate jump Jul 20, 2008
HMO premium rates for the Southeast are expected to rise 15 ... After plan changes, negotiations and terminations, final average HMO rates in 2008 for the Southeast actually rose 9 ... Nationally, HMO premium rates are expected to increase 11. (Memphis Business Journal, TN)
Dennis Clayson Jul 16, 2008
But during Sophmore year, just before finals, his roommate and he get popped with a bag of weed in their dorm ... So our little abortion survivor leaves school and fortunately lands a job at a meatpacking plant where he starts at a robust $9 an hour and a less than stellar HMO plan making strategic cuts in cattle carcasses 10 hours a day, on his feet. (Waterloo-Cedar Falls Courier)
My testament to proper care Jul 16, 2008
Currently, HMO outpatient treatment covers up to 24 visits per calendar year. Children and adults who suffer from mental illness such as post-traumatic stress disorder are subject to this limit. (Boston Globe -- Editorial)
Trend away from HMOs has reformers concerned Jul 15, 2008
Between 10 percent and 11 percent of its recent enrollment has been in plans with "leaner designs," including high-deductible and HSA-compatible versions of its traditional HMO products, said Wade Overgaard, Kaiser's senior vice president for sales and account management ... "There continues to be a movement toward leaner-type benefit options," Overgaard said, "to offset some of the premiums and costs of health care." He said Kaiser sees the trend continuing, as HMO enrollment regionally takes a... (San Francisco Business Times, CA)
LETTERS: NCT, July 13, 2008 Jul 14, 2008
If you choose to be a lower paid worker, then plan to be in an HMO. So you took a different course, you'll probably be in the cash-only line. Like most of the wealthy do. (North County Times)
HEALTH BLOG: Easy to digest nutrition news briefs Jul 8, 2008
Fitness and nutrition - Better Life - USATODAY.com. Kids and cholesterol. (USA Today -- Money)
Medicare Advantage: An Even Earlier Demise? Jul 8, 2008
The program with the somewhat Orwellian name allows Medicare beneficiaries to opt for an HMO over the government plan. Though it's counterintuitive that a senior citizen would dump all-you-can-eat coverage from the government for an HMO that can deny or limit care--more than one in five beneficiaries have done just that ... The reason: Medicare HMOs have more money to spend because they get 12% more per member than the government pays under its conventional plan. (Forbes -- Business)
Calif. Ignores $1M Fine Of Health Insurer Jul 5, 2008
The state's Department of Managed Health Care is the only stand-alone HMO regulatory body in the country, and is tasked with ensuring fair practice for more than 21 million enrollees. MMVIII The Associated Press. (CBS News)
Calif didn't try to collect Anthem Blue Cross fine Jul 5, 2008
"To be able to defend the citizens of this state, I have to be able to win in court. I have to make sure that we have defensible positions and we're getting the wins we need for enrollees."The state's Department of Managed Health Care is the only stand-alone HMO regulatory body in the country, and is tasked with ensuring fair practice for more than 21 million enrollees. Comments. (Fresno Bee -- Business)
PNC to review implementation of NHIS Jul 4, 2008
He said: "The NHIS is currently being implemented on one leg, hence the teething problems associated with its administration but unfortunately the ruling New Patriotic Party (NPP) has failed to consult the initiators. "Under a PNC Government in January 2009, the other leg of the scheme known as Health Maintenance Organization (HMO) would be outdoored to give full complement to NHIS," Dr Mahama stated at the last in a series of an interactive platform dubbed; "An Evening Encounter With... (Ghana Web, Ghana)
Post a comment » Jul 4, 2008
x-Navy wrote on Nov 14, 2007 9:55 PM:" I have a few questions that I have yet to make sense out of. Since when does not supporting the war mean that you're not supporting your troops? How does supporting the war, and voting to keep soldiers and sailors on the danger line so they can return to an inadequate HMO health care regulated system that will not provide proper treatment equate to supporting the troops? Where does the funding come from, who will be owed, and what does that mean for future... (Canton Daily Ledger, IL)
Window is closing on Congress' ability to address Medicare cuts Jul 4, 2008
Herseth Sandlin contends the bill makes modest reforms to private, fee-for-service Medicare Advantage plans, not the HMO and PPO plans that are more common in South Dakota. Those reforms would save an expected 12 billion over five years. (Rapid City Journal, SD)
UnitedHealth cuts outlook, sheds 4,000 jobs Jul 3, 2008
United Health bought , the third-largest HMO and PPO in Greater Sacramento, based on Business Journal research. Share of UnitedHealth were trading at $26. (Sacramento Business Journal, CA)
JCMG celebrates 15 years of holistic healing (774) Jul 2, 2008
At that time unlike any time in previous central Missouri history HMOs were sought after by employers, especially the state ... gofish wrote on Jun 30, 2008 8:51 AM:" The health care community always cuts Medicaid coverage claiming that the reimbursement rates are too low. When I get my benefits statements and see what my HMO paid the provider, it seems to me to be an unreasonably high amount for the service I received. It's no secret that my HMO helps pay for the uninsured, account write-offs,... (Jefferson City News Tribune, MO)
Staying Social May Keep Dementia at Bay Jun 27, 2008
For this new study, published in the July issue of the American Journal of Public Health, Crooks and her colleagues conducted telephone interviews with the women, all of who were members of the Kaiser Permanente HMO. The women were free of dementia when the study started in 2001. The team tested each woman's cognitive status by phone and reviewed her medical records to help assess it, as well. (Health-Finder)
Avoid the freshman fifteen this fall Jun 26, 2008
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Blue Shield of California Appoints Industry Veteran as New Vice President and General Manager for Senior Market Jun 25, 2008
In this new role, Stewart is responsible for providing strategic direction, business planning and overall leadership for the senior market lines of business, including Medicare Advantage HMO, Medicare Supplement and Medicare Part D Drug Plans. Kiner will report to Karen Vigil, senior vice president of Blue Shield's Individual, Small Group, and Government Business Unit. (PR Newswire)
Letters to the Editor (June 24) (54) Jun 25, 2008
And I'm not talking about HMO plans either. " CarpeDM wrote on Jun 24, 2008 5:48 PM:" A solar panel on a high rise would not have the square footage in size to handle the power requirements. (Corvallis Gazette Times, OR)
Readers' Platform: Treatment denied Jun 24, 2008
If your attorney can prove the HMO or insurer acted unreasonably according to the terms of the plan or policy, you might be entitled to punitive damages and payment of at least part of your attorney's fees by the insurer. Read your plan. (San Francisco Chronicle -- Business)
Medical care's state of denial Jun 24, 2008
Last year, the state's HMO Help Center received nearly 90,000 calls from consumers asking for help in resolving their health plan woes. About 7,000 Californians have taken advantage of third-party medical reviews since 2001, when the state Department of Managed Health Care started offering them. (San Francisco Chronicle)
Letters from readers Jun 21, 2008
- Perhaps one of the biggest drawbacks, the lack of co-payments and/or coinsurance on most HMO insurance plans. Socialized medicine will be a disaster in this country. (Florida Times-Union)
CalPERS signs off on health care premium increases Jun 20, 2008
Basic health maintenance organization (HMO) rates will rise not quite 6 ... Statewide, basic CalPERS HMO rates for 2009 will increase from 3. (Sacramento Business Journal, CA)
