A windfall without the risks
Article Abstract:
Managed care companies which have assisted establishing provider-sponsored plans such as PacificCare, Anthem, Health Net, United Healthcare, and Blue Shield of California stand to profit a lot following Congressional approval allowing them to contract directly with Medicare. The legislative move was actually aimed at reducing costs by encouraging existing HMOs to compete with new providers. As an example, Louisville, KY-based Humana subsidiary MedStep's contract with United Health Group hospital system 'to develop a Medicare health plan serving northeast Wisconsin' will allow MedStep to earn a 14% to 18% share of United Health's Medicare payments based on a minimum of $367 per member per month.
Comment:
Managed care companies assisting provider-sponsored plans direclty w/ Medicare may earn generously
Publication Name: Hospitals & Health Networks
Subject: Health care industry
ISSN:
Year: 1998
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A windfall without the risks
Article Abstract:
Since Congress has allowed provider sponsored plans to contract directly with MEdicare, health maintenance organizations have found a windfall by contracting to market the plans. MedStep of Kentucky has a contract with United Health of Wisconsin to develop a Medicare sales and marketing plan in exchange for at least 14% of the Medicare payments. Problems with this arrangement may arise if the HMOs market to higher risk seniors since their risk is not associated with the plan's.
Publication Name: Hospitals & Health Networks
Subject: Health care industry
ISSN:
Year: 1998
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Kaiser's squeeze play; still smarting from '97 losses, can the managed care giant get fit and trim fast enough?
Article Abstract:
Kaiser Permanente may have to divest itself of some of its business line in the face of the $270 million loss it sustained during FY 1997. The loss was the first for the HMO and exceeded analysts estimates. It is probable that Kaiser may sell or spin off parts of its system, especially health plans in Kansas, North Carolina, Ohio and Texas that have been losing money.
Publication Name: Hospitals & Health Networks
Subject: Health care industry
ISSN:
Year: 1998
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