Word: contracting
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Dates: during 1990-1999
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Heinze scored his second goal of the season 1:18 later on a rebound. Ted Donato, who missed Boston's first seven exhibition games during a contract hold-out, tipped Grant Ledyard's shot. Salo stopped the deflection, but the puck went to Heinze, who put a 10-footer past the goalie from the left side...
...million deficit this year. Much of the money for the expansion comes from borrowing--$280 million. But Snyderman is convinced that growth will pay off, in no small part by making Duke the hospital of choice for enough patients and doctors that it can obtain more favorable contract terms from HMOs for patient care. "What we need is sufficient market clout that we cannot be rolled over," he says...
...doctors Snyderman represents a shift of power from the stethoscope to the calculator. In 1993, he replaced a longtime department chair with a doctor who also held an M.B.A. A group of dissidents petitioned Duke's board of trustees protesting the changes. But Snyderman survived, and last May his contract was extended again for five years...
What makes an IPA different from a regular managed-care company is that the doctors who are giving the care are also calling the financial shots. PrimaHealth is owned and operated by doctors from Duke and the surrounding area. It has contracts with insurance companies to provide the doctors' services under those plans. Once it has the contract, PrimaHealth doctors, not the insurance company, make the decisions about how patients will be cared...
Traditional managed-care companies don't agree that IPAs will provide better care. They note that IPAs like PrimaHealth contract to cover patients on a "capitated" basis. That means they are paid a set amount per patient per year, and keep any money that is not spent. This gives them an incentive to be careful about how much treatment they provide--much like traditional insurers, who point out that they too have doctors on staff to make medical decisions. In the end, they argue, a well-managed IPA will probably make roughly the same decisions as a traditional insurer. "Everyone...