Word: hmos
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HPHC also has a historical tie to the University. In 1969 Robert H. Ebert, then dean of HMS, created Harvard Community Health Plan, one of the first three HMOs in the country and persuaded the University to give its name to the plan. Through various mergers, this group would later become HPHC...
There are real health risks in this new tightfistedness. Since there's little or no scheduled follow-up, the ED is not the best place to get general medical care. In many states, ED doctors are concerned that HMOs require trauma patients, once they're stabilized, to be moved to an in-plan hospital too soon. And specialists in California, fed up with managed care's unwillingness to compensate them fully, are rebelling against providing voluntary, on-call backup, a critical component of the ED system. To keep them on duty, some hospitals have to fork out $1,000 daily...
There's a good chance she'll get one. These days, many HMOs as well as Medicare dispute claims on the basis of what constitutes an emergency--rejecting one if, say, a patient who thought he had a heart attack turned out to be suffering from mere heartburn. "We are caught in the middle," says Dr. Stephan Lynn, residency director in the ED at St. Luke's--Roosevelt Hospital in Manhattan, where the medical staff has been cut 15% to 20% over the past five years even as the number of visits has risen 25%. "I get letters from patients...
...moneymaking parts of the hospital. But with the funding cuts in 1997's balanced-budget agreement added to managed care's fiscal pressures, that cushion has all but disappeared. And later this year, new Medicare payment schemes could cause even greater pain for both EDs and ambulance services. "The HMOs and the government have taken the fat out of the system, which used to cover the cost of emergency care," says Dr. Leo Berkenbile, who runs the ED at Verdugo Hills Hospital in Glendale, Calif., the state where EMS is most under siege...
...aircraft carrier the Pentagon doesn't want. But when the subject turns to the dining-room-table issues that top every list of voter concerns--education, health care, moral values--McCain seems to lose some fire. In last week's debate, he took a question about how to fix HMOs--an issue as salient as they come--and not once but twice pivoted to talk instead about Internet taxation...