Can plans manage the preventive care diabetics need?

Article Abstract:

Expensive treatments for diabetics save money in the long run, by avoiding even more costly care for emergencies related to complications of diabetes such as kidney failure, eye damage and acidosis. However, managed-care plans may emphasize short-term financial results rather than overall health maintenance procedures. Expenditures for the care of diabetics made up 14% of total costs in 1992, four time the costs associated with other patients.

Health Care, Health Care and Social Assistance, Preferred Provider Health Plans, Care and treatment, Economic aspects, Medical care, Diabetes, Diabetes mellitus, Preventive health services, Preventive medicine, Preferred provider organizations (Medical care)

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HMOs fear pay trouble under Ill. Medicaid managed care

Article Abstract:

Commercial HMOs are proving reluctant to participate in an Illinois Medicaid program that requires children, women, and the disabled to participate in managed-care programs. The program provides capitated payments for just 60% of the services that HMOs will provide, leaving them concerned about revenue shortfalls. However, the state will reimburse participating HMOs on a fee-for-service basis for services not covered by capitated payments.

Contracts, Social policy, Illinois

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Medicaid misgivings

Article Abstract:

Medicaid managed care began operating in Mississippi in 1996, the state with the most poor, the fewest doctors, few health maintenance organizations and the worst health status. Some physicians with the largest amount of poor patients will not be participating in the Medicaid managed care program. Major losses for some Medicaid health maintenance organizations are attributed to patients with costly chronic conditions.

Hospital and medical service plans, Medical Care Insurance, Health aspects, Mississippi, Health insurance

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