Word: hmos
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Dates: during 1990-1999
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More than 400,000 medicare beneficiaries received a "Dear John" letter last month, but it wasn't from their sweethearts. It was from their HMOs. Thanks to increasing medical costs and decreasing federal reimbursements, taking care of patients over 65 is not so profitable a business as it was in the early 1990s. So as of Dec. 31, more than 90 HMOs across the U.S.--including Aetna, Humana and Oxford--will stop serving Medicare customers in certain regions around the country...
...options: you can enroll in another HMO, or you can opt for "traditional" Medicare coverage, in which you choose your doctor and pay certain deductibles for hospitalization and a 20% co-payment on other services. By law, your soon-to-be-ex HMO must inform you of alternative HMOs. But it's still up to you to call those HMOs and see whether they offer a plan that's right for you--say, one that covers prescription drugs (as traditional Medicare does not). Don't wait until the last minute to do this because the best HMOs are likely...
...never seen. The most important "contract" in medicine is, and always will be, between the physician and the patient and his or her family. Until Congress completes the work of protecting patients' rights, health care will continue to take second place to the financial health of the insurers and HMOs. GARY R. SCHAFER, M.D. Rutherfordton...
...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...
...commercials: dub in the triumphant music, fade out with mother embracing child. But this is no ad, nor is PrimaHealth an HMO. It's a rarer species in the managed-care jungle, called an independent-practice association. IPAs are groups of doctors who band together to act like HMOs. Some medical observers believe that if IPAs like PrimaHealth spread, they could make managed care a lot more patient-friendly...