Word: hmo
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...into the already convoluted politics of Medicare. The trade association for the managed care industry announced that HMOs would be increasing premiums or cutting benefits for most of the 6 million Medicare patients enrolled in their programs next year. Worse, some 250,000 Medicare patients would be dropped from HMO rolls altogether. The reason: The federal reimbursements for taking on Medicare patients are insufficient, said the industry. Medicare officials disagreed, but they limited their immediate public reaction to that of a muted ?disappointment? over a development that could seriously complicate President Clinton?s attempt to reform Medicare and expand...
...Another major point was that such economies allowed many HMOs to provide prescription drug coverage. But the latest move by the industry throws many of these assumptions up in the air. Moreover, the development comes at a time when a growing number of patients have started to complain about HMO policies that smack of practicing medicine on the cheap. ?This has put the President in the position of backing a patient bill of rights against HMOs while he also presses them to take care of the elderly,? says Dickerson. The result is that HMOs have decided to fight back, leaving...
...thinking about the unthinkable: forming a union. The idea of taking a cue from blue-collar-labor history is one of the hottest topics at this week?s convention of the American Medical Association in Chicago. Many doctors around the country are growing increasingly frustrated at the restrictions that HMO money-vetting procedures have imposed on the exercise of their medical judgment. And a growing number of them want to do something about...
...merged with Aetna) and some Blue Cross/Blue Shield plans helped bankroll three of the recent studies, an act of good corporate citizenship that seemed to signal a willingness to keep paying for transplant treatments in breast-cancer cases. A doctor working with Kaiser-Permanente, the nation's largest HMO, offers more direct reassurance. "It will be up to the doctor and the patient," predicts oncologist Louis Fehrenbacher...
...HMO Though health-maintenance organizations have been bashed for years, a study out last week finds they do a pretty good job of diagnosing and treating breast cancer in the elderly. On average, HMOs are more likely than traditional fee-for-service practices to detect the disease early. And they are just as likely as traditional centers to do a breast-conserving lumpectomy rather than a mastectomy...