Word: hmos
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What no one has ever figured out is who should foot the bill. Many HMOs wanted no part of the treatment, branding it as experimental. The problem is, the only way to change that designation is for women to undergo the treatment as part of a clinical study. And that gets pricey unless insurance companies chip in. "Insurers should be willing to pay," says Dr. John Durant, of the American Society of Clinical Oncology. "They'd probably save money with fewer relapses and more premiums...
...HMOs that have been disinclined to offer coverage, however, last week's news offers little incentive to do things differently. Legislative pressure--plus the ongoing threat of more jackpot lawsuits--may yet force the hands of those holdouts. But whether that will be enough for women like Tawnya Geisbush, still awaiting an O.K. from her insurer, is unclear. "I have a fairly small window of time to work with," she says. By the time the company is persuaded, one way or the other, her window may have already closed...
Hsiao first attained prominence when his criticisms of Medicare in 1986 led to its reform and made HMOs (Health Maintenance Organization) a household word...
ALTERNATIVE COVERAGE Massages and acupuncture may seem like strange, exotic remedies, but more HMOs are starting to treat them as medicine worth paying for. An estimated two-thirds of the nation's HMOs, in fact, now cover some kind of alternative health care, typically chiropractic, acupuncture or massage therapy, according to a new study by Landmark Healthcare. In the future look for HMOs to expand coverage for vitamin therapy and acupressure, though you may still have to pay for kava or ginkgo out of your own pocket...
...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...