Tackling the payment question

Article Abstract:

Medicare gives health maintenance organizations (HMOs) the option to receive payment based on cost or monthly fees based on risk. The calculation of risk varies according to each county's adjusted average per-capita costs. However, HMOswith healthier patients receive about 6% higher payments than the average for Medicare, according to a study by Mathematica Policy Research. Medicare may ask HMOs to bid competitively for contracts.

Administration of Public Health Programs, Health Care Services, Care and treatment, Aged, Elderly, Management, Medical care, Medicare

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Oxford losses raise concerns for industry's staying power

Article Abstract:

Oxford Health Plans Inc., based in Darien, CT, forecasts about $49 million in losses for the third quarter of 1997, compared to profits of about $37 million in the previous quarter. Analysts blame the HMO's problems on unforeseen medical and administrative costs. Oxford was forced to pay interest to physicians who sued for late payments, which were attributed to computer glitches.

Oxford Health Plans Inc., OXHP

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