Word: hmos
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...insured Americans are under so-called managed care: 20% in health-maintenance organizations, which provide all or most medical services under one roof, and 44% in preferred-provider organizations, which negotiate prices in advance with certain doctors and hospitals. Although adherents fiercely debate their relative merits, the principle of HMOS and PPOS is the same: controlling costs by having the insurer "manage"--that is, limit--the consumer's choices...
...comes from Congress, which is moving toward substantial reductions in the growth of Medicare spending and major cuts in the funding of the National Institutes of Health, two important sources of subsidy for teaching hospitals. But the greatest long-range problem is the relentless spread of health-maintenance organizations (HMOS) and managed-care networks. Teaching hospitals traditionally have charged heavy fees for fairly routine procedures to cover the high costs of training and research. Cost-conscious hmos and insurance networks frequently refuse to pay those prices. Since the teaching hospitals cannot survive by performing liver transplants and brain surgery alone...
...take over some of the more routine duties of higher-paid registered nurses. And in a kind of if-you-can't-lick-'em-join-'em move, UCLA is purchasing Santa Monica Hospital in order to launch its own managed-care network. It is also cutting deals with local HMOS -- for example, to perform all transplant surgery for subscribers to the giant Kaiser Permanente plan in Southern California...
...lose some $16 million. "We are supposed to provide all the same services and do it with less. Medicare, to its credit, is the only payer that contributes anything to the cost of medical education, and that has got to change.'' UCLA has already talked with several local hmos about a premium tax to finance teaching functions. Others have suggested imposing such a surtax on all insurance premiums. Says Bruce Kelly, the director of government relations at Mayo: "We endorse a set-aside program to fund research and teaching.'' But a delegation of teaching-hospital administrators who visited Capitol Hill...
...Brien agreed, saying health care costs are currently volatile because both Congress and the Clinton Administration are weighing several plans to reform health maintenance organizations (HMOs) and public care facilities...