Lawsuits embroil military managed competition test

Article Abstract:

Three health plan companies, Foundation Health Corp, Qual-Med Inc and Well-Point Health Networks Inc, have filed suit against the Department of Defense after losing bids to Aetna Life & Casualty Co for a military managed health care system. The program, an experiment of the Civilian Health and Medical Programs of the Uniformed Services, is to run five years and provide medical coverage to about 750,000 military retirees in Hawaii and California. Foundation, which has run a plan in Hawaii since 1988, has seen its stock decline from 44 3/4 to 18 3/4 by Aug 23, 1993.

Direct Health and Medical Insurance Carriers, Medical Care Insurance, Administration of Public Health Programs, Military Health Services, Cases, Health care industry, Unfair competition (Commerce), Unfair competition, Health insurance, Civilian Health and Medical Program of the Uniformed Services, Foundation Health Corp., Well-Point Health Networks Inc., QualMed Inc., QLMD, FH

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Large California HMO switches to for-profit status

Article Abstract:

Health Net, the second-largest health maintenance organization in California, has changed from a non-profit company to a for-profit company. As required by federal regulations, Health Net had to donate the fair market value of the company to a charity with a similar business. Hence, the California Wellness Foundation received $300 million and an 80% ownership stake in Health Net. Motives for the conversion included access to capital markets and the possibility of an employee stock ownership plan.

Finance, Health maintenance organizations, California Wellness Foundation, Health Net of California Inc.

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California Blue Cross is using its market power

Article Abstract:

California Blue Cross has cut physician fees in some specialties by 6% to encourage the use of primary care and to cut costs. In one change, the group has lowered the reimbursement for Caesarian sections to discourage unwarranted operations; the organization's C-section rate is higher than the national average of 23%. The California Medical Association charges that the group is using its economic muscle to force the fee cuts and needs revenues to finance its new for-profit health network.

Offices & clinics of medical doctors, Accident and health insurance, Management, Compensation and benefits, Physicians, Medical professions, Blue Cross of California

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