On the defense: medicine fights moves by Blues plans to squeeze physicians out

Article Abstract:

State Blue Cross and Blue Shield organizations are beginning to form preferred provider networks that exclude many physicians. The organizations are trimming their physician lists to include only physicians that conform to their desired mix of specialties and who operate cost-effective practices. However, physicians groups such as the American Medical Association insist that physicians should be included on any such list that they wish. At the very least, physicians are pressuring the organizations to offer an appeals process if they are rejected from a list and to release the data on which they were judged.

Offices & clinics of medical doctors, Accident and health insurance, Usage, Health insurance industry, Preferred provider organizations (Medical care)

---

Out of the hospital, into unknown future

Article Abstract:

Several types of outpatient services, such as laparoscopic and arthroscopic surgery and home health care, provide significant savings for patients. Savings on surgical costs at an outpatient ambulatory care center are as high as 45% over hospitalized surgery. Home health care averages $70 per visit, much less than the average $820 per day for a hospital room. However, managed care providers are limiting such outpatient services because usage of these services has increased. Insurers also are concerned that more outpatient services could lead to decreased quality of medical care.

Outpatient Care Facilities, Outpatient Care Centers, HEALTH SERVICES, Home health care services, Home Health Care, Ambulatory care facilities, Medical care utilization, Managed care plans (Medical care), Ambulatory medical care, Home care services, Ambulatory care utilization

---

Similar abstracts:

• Abstracts: AMA board backs broader nonbias policy. Disabilities act will turn some physicians into plaintiffs. Organized medicine's open door
• Abstracts: Medicare changes come down to wire: pay for ECG, new physicians in question
• Abstracts: Plastic surgeons ponder future of implant surgery. Are hospitals squeezing physicians for kickbacks? Pa. Medical Society issues ultimatum on tort reform
• Abstracts: VA Medicare demonstration project faces uphill battle. Outcomes research will lead to better care, supporters say

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.