{"title":"Innovative providers thrive under Medicaid managed care.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A publicly funded health care system embraces Medicaid managed care. To some safety net providers, providing quality care, serving the indigent, and providing medical training seem to conflict with managed care. See how the University Health System in San Antonio, TX, created new programs for its Medicaid and uninsured patients to meet its mission, compete with commercial Medicaid plans, and still survive.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 7","pages":"100-4"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21400825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use these benchmarks to assess the strength of your Medicare HMO.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Data File: For Medicare HMOs, it's all about money. Benchmarks and trends data from InterStudy show how managed care penetration, capitation rates, and medical loss ratios can give providers clues on plan viability and performance.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 7","pages":"108-9"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21400827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adopt geriatric model to succeed in managed Medicare.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 6","pages":"81-5"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21398908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Boost your bargaining clout in contract negotiations with Medicare managed care plans.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Boost your clout in negotiations with Medicare plans. Find out what Desert Physicians Association in Mesa, AZ, has learned in its dispute over reimbursement rates with CIGNA, and get some advice from a Medicare managed care consultant on how to negotiate contracts with Medicare plans.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 6","pages":"85-6"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21398909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Study of five Medicare plans finds 10 budget-busting drugs.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 6","pages":"92-3"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21398912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Providers develop health plan to manage Medicaid patients without woes of HMOs.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Managing Medicaid lives without HMOs. Providers in Pitt County, NC, have developed their own kind of managed care plan that brings together traditional Medicaid providers with private physicians seeking to improve care quality and patient access. Providers in the plan hope it can keep commercial HMOs out of the local Medicaid business.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 6","pages":"86-8"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21398910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cut inpatient utilization in half with proper use of home health services.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 6","pages":"93-5"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21398913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medicaid plans collaborate to improve birth outcomes, ease data reporting problems.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Collaboration in Medicaid solves providers' data reporting troubles. If you're looking for effective ways to give plans the information they want on pregnant Medicaid members and you want good programs for your high-risk patients, see how plans and providers in Philadelphia collaborated to improve birth outcomes.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 6","pages":"89-92"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21398911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prepare for scrutiny of your role in Medicare appeals.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 5","pages":"65-72"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21398425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Seniors relying on Medicare as sole health care insurance may turn to Medicare+Choice.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Data File: Seniors most likely to join Medicare+Choice plans are those with no other source of medical insurance who want the most benefits they can get at the lowest out-of-pocket cost. A study by the Employee Benefit Research Institute finds the numbers of seniors in this category are increasing, especially among the poor, women, minorities, and those over age 85.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 5","pages":"75-7"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21398428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}