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hmo

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Case Study VII-Keystone Health Plan East (Philadelphia, PA) Baby BluePrints/Baby FootSteps: The program includes a strong emphasis on breastfeeding education and support for all pregnant members Keystone Health Plan East's goal for breastfeeding promotion is "to inform women about the benefits of breastfeeding and to support those who decide to do so, without in any way making formula-feeding mothers feel guilty...; Tags: Gender and diversity, HEALTHCARE, HMO, women, line of business, health care, benefit; Case studies
Health Maintenance Organizations and the Changing Physician Workforce: The composition of the U.S. physician workforce and its geographical distribution are critical to the efficient functioning of the health care system and the provision of quality health care. Many analysts believe that the growth of managed care in recent years has decreased earning opportunities for specialists while not affecting,...; Tags: Vertical industries, HEALTHCARE, RAND Corp., physician, HMO, health care, workforce; White papers
Drug Discount Peddlers: By gathering and automating huge amounts of pharmacy pricing data and making it widely known, Pharmacy Benefit Managers (PBMs) have certainly exerted a strong downward pressure on retail drug costs. And they have helped employer drug programs fit nicely into managed-care plans, bringing the co-payment features typical of health maintenance...; Tags: HEALTHCARE, Benefits, Vertical industries, Insurance, CFO Publishing Corp., HMO, health insurance, health care, hiring, incentive, pricing strategy, benefit; White papers 2005-10-28
Did the hmo Revolution Cause Hospital Consolidation?: During the 1990s US healthcare markets underwent a significant transformation. Managed care to become the dominant form of insurance in the private sector. Also, a wave of hospital consolidation occurred. This paper explores whether the rise in managed care caused the increase in hospital concentration. It uses instrumental variables approach...; Tags: HEALTHCARE, National Bureau of Economic Research, HMO, insurance, health care; White papers 2005-01-01
Quality Oversight in Medicaid Primary Care Case Management Programs: As Health Maintenance Organizations (HMOs) have curtailed participation in Medicaid, enrollment in Primary Care Case Management (PCCM) programs has grown. To examine state Medicaid agencies' monitoring of PCCM and HMO programs, this paper talks about a survey of Medicaid agency directors of forty-six states and the District of Columbia. Agencies...; Tags: HEALTHCARE, Project HOPE, Medicaid, HMO, enrollment, health care, performance, agency, monitoring, survey, strategy; White papers 2004-12-01

A Broader Vision for Managed Care, Part 3: The Scope and Determinants of Community Benefits: Managed care plans have been encouraged to address the health of the communities in which they are located. This paper presents the first nationally representative portrait of Health Maintenance Organizations' (HMOs') community benefit activities, based on survey data from 1999. It finds that HMOs were engaged in a wider variety...; Tags: HEALTHCARE, Project HOPE, HMO, health care, Medicaid, benefit, vision, survey; White papers 2004-06-01
Overlap in hmo Physician Networks: Health Maintenance Organizations' (HMOs') restrictions on the size of their physician networks may facilitate cost containment and quality improvement activities but may also impede access to care and impose barriers to those wishing to switch health plans or jobs. This paper examines the extent, variation, and predictors of overlap in...; Tags: HEALTHCARE, Project HOPE, HMO, overlap, physician, health care, barrier, job; White papers 2004-04-01
Medicaid Managed Care: The Last Bastion of the hmo?: States rely on Health Maintenance Organizations (HMOs) for their Medicaid beneficiaries because they offer guaranteed access to comprehensive benefits at a predictable cost. This is true despite movement away from HMOs, or at least the more restrictive variants, in the private sector. Plans that focus on Medicaid are becoming more...; Tags: HEALTHCARE, Project HOPE, Medicaid, HMO, health care, insurance, benefit; White papers 2004-04-01
The State of the hmo Industry: This report focuses on financial performance, valuation, merger and acquisition activity, and industry highlights primarily among the publicly traded managed care companies for the year 2003. The report divides the universe of publicly traded managed care companies into two distinct groups: the National HMOs, which have operations in multiple regions...; Tags: HEALTHCARE, Mergers & Acquisitions, HMO, M&A, valuation, merger, financial, industry; White papers 2003-12-10
The Magnitude and Nature of Risk Selection in Employer-Sponsored Health Plans: Most existing studies of risk selection in the employer-sponsored health insurance market are case studies of a single employer or of an employer coalition in a single market. The paper examines risk selection in the employer-sponsored market by applying a "switcher" methodology to a national, panel data set of enrollees...; Tags: HEALTHCARE, Benefits, National Bureau of Economic Research, HMO, health care, health insurance; White papers 2003-08-01
Health Insurance Reform and hmo Penetration in the Small Group Market: The paper uses data from several national employer surveys conducted between the late 1980s and the mid-1990s to investigate the effect of state-level underwriting reforms on HMO penetration in the small-group health insurance market. The paper identifies reform effects by exploiting cross-state variation in the timing and content of reform...; Tags: HEALTHCARE, Benefits, Insurance, University of California, HMO, health insurance, health care, survey; White papers 2003-05-01
Legal Considerations Underlying A Liquidation Plan For A Managed Care Organization: This paper discusses legal considerations relating to a plan for liquidating a managed care organization ("MCO"). The focus is upon health maintenance organizations ("HMO"), with the assumption that the liquidation will be administered in a state receivership court, rather than in a federal bankruptcy court. Topics discussed below include the...; Tags: HEALTHCARE, HMO, liquidation, health care, regulation, bankruptcy, insurance; White papers 2003-01-01
Managed care: Patients in high HMO areas may be less likely to receive angiography when compared to areas with low levels of managed care, although this result was only marginally significant. In unadjusted comparisons, patients in high HMO market share areas had lower 30 day mortality, but there were no differences in...; Tags: HEALTHCARE, National Bureau of Economic Research, HMO, patient; White papers 2003-01-01
California Employee Compensation and Benefits Law Developments: This article is about California Assembly Bill (“A.B.”) 1401 which states that insurance carriers and health maintenance organizations (“HMOs”) in California to permit individuals who exhaust their group health plan continuation coverage under the federal COBRA law to extend their continuation coverage up to 36 months from the start of...; Tags: HEALTHCARE, Vertical industries, Benefits, Pillsbury Winthrop LLP, HMO, health care, California, compensation, insurance; White papers 2002-12-31
Health Maintenance Organization Insolvency: Bankruptcy Jurisdiction or State Proceedings: The Constitution of the United States accords Congress the authority to enact federal laws governing bankruptcies because the constitution does not accord exclusive bankruptcy authority to the federal government, states are free to enact their own insolvency laws unless Congress has enacted an applicable federal law. The trend appears to...; Tags: Litigation, HEALTHCARE, HMO, bankruptcy, health care, U.S. Congress; White papers 2003-01-01
Does the Medicare Principal Inpatient Diagnostic Cost Group Model Adequately Adjust for Selection Bias?: This paper examines bias in Medicare Principal Impatient Diagnostic Cost Group model due to unobserved selection using HMO and FFS hospital use data. The objective of this dissertation is to determine whether the principal inpatient diagnostic cost group (PIP-DCG) model adequately adjusts for HMO (health maintenance organization) favorable selection, and,...; Tags: HEALTHCARE, RAND Corp., HMO, Medicare, health care; White papers 2002-10-04
Comparison Summary for Members: The State Health Benefits Program Comparison Summary provides an easy way for employees and retirees to compare the benefits of the various plans offered by the State Health Benefit Program by summarizing what benefits each plan provides for a specified service. The State Health Benefits Program offers three types of...; Tags: Benefits, HEALTHCARE, HMO, benefit, health care; White papers 2002-01-01
Squeezed hmos Asking Employers for 20 Percent Premium Hikes: Employers who have already dipped their toes in the water have, in fact, gotten the bad news: In a time of low inflation, HMO premiums are heading straight up - and rising faster than expected. Having gobbled up smaller hospitals or forced them out of business, large hospital systems now...; Tags: HEALTHCARE, CFO Publishing Corp., HMO, inflation; White papers 2001-07-30
Mergers, Acquisitions Afoot In Disease Management Industry: The issue raised in the article is that within a few years, there may be only 30 DM companies left. HMO customers want vendors to handle more than one condition. While most of the DM specialists started by working with health plans and physician groups on a single disease, HMOs...; Tags: HEALTHCARE, HMO, physician, merger, health care, industry, Internet; White papers 2000-09-01
The Facts about PPOs, hmos, FFS and POS Plans: The article says that most common form of health insurance today is known as managed care. Within the managed care umbrella, you'll find three types of plans ? health maintenance organizations (HMOs), preferred provider organizations (PPOs) and point-of-service (POS) plans. HMOs and PPOs are the most popular type of plans,...; Tags: HEALTHCARE, Vertical industries, Benefits, AllBusiness.com, HMO, point-of-sale, health care, health insurance; White papers 1999-01-01