Word: hmos
(lookup in dictionary)
(lookup stats)
Dates: all
Sort By: most recent first
(reverse)
Cases against HMOs have their place - but it's not in federal court. In a unanimous decision, the Supreme Court ruled Monday that health maintenance organizations cannot be sued under federal law. And while HMOs viewed the decision with jubilation, it hardly heralds the end of anti-HMO litigation; the Justices' opinion left the door wide open for cases to be heard in state courts...
...impossible to cut costs any more. HMO enrollment is slowing; medicare reimbursements are too low; and hospitals and doctors are fighting back against deep fee discounts--in some cases dropping out of networks altogether. More people are opting for flexible plans, choosing preferred-provider organizations over HMOs (see sidebar). Says Tom Ferguson, a health-care consultant at William M. Mercer: "There's less incentive for providers to ration care...
...gatekeeper means more direct access to care. Recently, PPOS have emerged as the leaders of the pack. Most adopted a $10 co-payment to MDs within their networks, originally an HMO feature. Unlike HMOs, the PPOS do not require their doctors to seek approval before performing services. PPOS have also become more competitive as HMO premiums have risen...
...This option was created by HMOS to let members see doctors outside the network, but freedom predictably comes with a higher price. An HMO with broad networks like CIGNA's, though, only has a small fraction of POS members actually seeking care outside the network...
...also spoke about prescription drugs and HMOs, saying, "You want your doctor to be the one making decisions, not some bureaucrat in the government...