Health benefits inspire a rush to the altar, or to divorce court Aug 13, 2008
More than romance, the couple readily acknowledge, it is Huggins's Blue Cross/Blue Shield HMO policy that is driving their rush to the altar. In a country where insurance is out of reach for many, it is not uncommon for couples to marry, or even to divorce, at least partly so one spouse can obtain or maintain health coverage. (International Herald Tribune)
Post a comment » Aug 13, 2008
x-Navy wrote on Nov 14, 2007 9:55 PM:" I have a few questions that I have yet to make sense out of. Since when does not supporting the war mean that you're not supporting your troops? How does supporting the war, and voting to keep soldiers and sailors on the danger line so they can return to an inadequate HMO health care regulated system that will not provide proper treatment equate to supporting the troops? Where does the funding come from, who will be owed, and what does that mean for future... (Canton Daily Ledger, IL)
What's Up, Docs? Aug 13, 2008
Dave Duval might have died had he waited for either his HMO or a famous medical center to accurately diagnose his symptoms ... Health maintenance organizations (HMOs) in California must offer patients a second opinion, but it often must come from within the group's physician network ... After Duval's HMO spent months unsuccessfully trying to figure out what was causing his fever, night sweats and fatigue, he left the security of his insurance coverage and headed to Mayo Clinic for more extensive... (San Diego Union-Tribune)
American Heart Association Aug 12, 2008
Overall, that program utilized electronic data from some 15 HMOs in the HMO Research Network to look at the epidemiology, prevention and management of heart disease. Kaiser says that the chance for its patients of dying of a heart attack or stroke is 30 percent lower than it is for the general population, although the figure does not account for age and gender or socioeconomic differences between the populations. (East Bay Business Times, CA)
Hospitals could be stuck with the bill for mistakes Aug 11, 2008
Philadelphia s three Medicaid HMO plans are each taking steps toward following the s lead and not paying hospitals for the extra cost of care related to preventable medical errors ... Kenneth J. Braithwaite II, regional executive for the (DVHC), said local hospitals are pushing for the Medicaid HMO plans to adopt the same type of process and system being used by the state welfare department with regard to nonpayments for medical errors ... We re looking for [the HMOs ] policies to be clinically... (Philadelphia Business Journal, PA)
HEALTH BLOG: Are fruit drinks or soda worse for diabetics? Aug 11, 2008
Blue Cross/Blue Shield of Michigan created an HMO and a preferred provider organization, or PPO, that give employees discounts of up to 20% on copayments and employers and employees discounts on premiums if employees agree to "adopt a healthy lifestyle," complete a health-risk appraisal questionnaire and have their doctor verify every year that they're sticking with their healthy lifestyle plan. In 2007, nearly 40% of employers said they'd start paying employees for "health-enhancing behaviors"... (USA Today -- Life)
Psychiatrist Blumenthal Investigated In '02 Faces 2 Unrelated Complaints Aug 11, 2008
At the time that Blumenthal issued his 2002 report, Benet was the founder and medical director of Psych Management Inc., a firm that Anthem Blue Cross-Blue Shield hired to manage mental health care for Anthem's HMO.. Blumenthal found that Anthem's low payments to Psych Management, also known as PMI, combined with financial misdeeds by Benet, resulted in at least one patient, and probably others, being denied necessary mental health care. (FOX61, CT)
In Sickness And In Health Aug 10, 2008
Ask to see it in writing on your HMO's Web site or in your contract. And make sure you have an HMO number you can phone from overseas. (San Francisco Chronicle -- Travel)
Insurance Giant Leverages Technology to Enhance Offerings Aug 7, 2008
Each report includes information on: -- Competitive analysis -- Enrollment trends -- Company-wide financials -- HMO financials -- Consumer-driven products -- Medicare strategy -- Pharmacy -- Disease management About HealthLeaders-InterStudy HealthLeaders-InterStudy, a company of Decision Resources, Inc., is the authoritative source for managed care data and analysis. For more information, please visit. (PR Newswire)
State fines CDPHP $600G Aug 7, 2008
CDPHP was cited when some of its lines -- its HMO product and several policies run by subsidiary Universal Benefits Inc. -- failed to provide this information for 121,911 claims submitted between 2004 and 2006, the department said. The Albany-based health insurer has agreed to contact members to make sure they received the proper notices. (Albany Times Union)
Blue Cross, HMO Colorado fined by state Aug 6, 2008
HMO Colorado Inc. also was cited for not disclosing policies for obtaining emergency medical services. We have made it clear that our mission is to protect consumers and this market-conduct examination and resulting fine reflects our commitment, Morrison said in a statement. (Denver Business Journal, CO)
Metropolitan Health Q2 earnings up 17% Aug 6, 2008
In June, the West Palm Beach-based company (AMEX: MDF), announced plans to sell its HMO to Humana for an estimated $14 million. That deal is expected to close by Oct. 1. (South Florida Business Journal, FL)
JEFF EDELSTEIN COLUMN: Insurance isn't porn, so why the blimp? Aug 6, 2008
I went with the HMO plan, with $50/$70 co-pays, 50 percent out-of-pocket for prescription drugs, and a $5,000 maximum for inpatient hospitalization. In other words, a pretty lousy plan. (The Trentonian, NJ)
Humana's Results Lift Managed Care Sector Aug 5, 2008
The program allows Medicare beneficiaries to opt for an HMO instead of the government plan, which is appealing to recipients since Medicare HMOs have about 12 ... (See " ") But HMOs, or health maintenance organizations that hire medical professionals to provide specified services to prepaid subscribers, are criticized for making big money off of Medicare-based programs ... 0 billion in sales and half of its profits from Medicare HMOs. (Forbes -- Markets)
Stop prostate exams at age 75, federal panel recommends Aug 5, 2008
"It sounds like a regulation promulgated by an HMO" to save money, said Dr. Dudley Danoff, president of Tower Urology in Los Angeles. "I don't think it is fair to a guy who is 75. Yesterday's 75 is not the 75 of the 1950s. . . . If you stop screening and treating men at 75, you are going to have a lot more people dying of prostate cancer.". (Los Angeles Times)
HEALTH BLOG: Read the latest child wellness tips Aug 5, 2008
Parenting and kids' health - Better Life - USATODAY.com. Unhappy about Happy Meals and the like. (USA Today -- Money)
Humana reports lower 2Q net income Aug 5, 2008
Humana has a large presence in Wisconsin with 435,000 total members, of whom 191,000 are self-funded, 98,000 are HMO or PPO customers and 126,000 are Medicare members. Reader Comments. (Milwaukee Business Journal, WI)
REGION: Hospital bond ballots start flowing in Aug 3, 2008
The people making the money are the HMO. Hospitals run on a 1 to 2 percent margin and they cannot afford to make this type of upgrade on operations alone. (North County Times)
Obituaries for Aug. 2 Aug 2, 2008
Service: Mass, 10 a.m. Monday, Notre Dame deLourdes Catholic Church, Fairview Road and Michigan Avenue, Swarthmore. Visitation: 8:30-9:30 a.m. Monday at the White-Luttrell Funeral Home, 311 N. Swarthmore Ave., Ridley Park ... Throughout his medical career, Dr. O'Neill was an active member of the Delaware County Medical Society and was instrumental is starting the Delaware Valley HMO in 1971, the first HMO in Pennsylvania. (The Delaware County Times, PA)
Small firms part of United gameplan Aug 1, 2008
The traditional HMO plan, which has been a niche plan for UnitedHealthcare in East Tennessee and parts of Virginia, Illinois and Iowa, targets small business owners with between two and 99 employees. This article is for Paid Print Subscribers ONLY.. (Nashville Business Journal, TN)
Senior Subjects: Drugstore clinics may be coming soon Jul 30, 2008
By Rob Stuart-Vail/Columnist. Tue Jul 29, 2008, 08:11 PM EDT. (Lincoln Journal, MA)
Haggling Can Lower Health Costs, Some Say Jul 30, 2008
"If you have, say, Crohn's disease, you want to designate your primary care physician as your specialist in your HMO, if you can.". "Although employer coverage usually is still your best bet, you may do better on your own," wrote columnist Kimberly Lankford. (Click2Houston, TX)
Grabbing The HMO Rebound Jul 28, 2008
Shares of UnitedHealth Group (nyse: - - ) and those of its HMO comrades have declined significantly over last six months ... Competition among HMOs is intensifying; the weak economy is not helping, as employers are looking for ways to save money and downgrading their health care coverage ... HMOs have underestimated their medical costs. (Forbes)
Editor's notes: Not the only one blowing smoke Jul 27, 2008
If Fallon, my HMO, chooses to increase the amount I pay for coverage because I smoke, then I d be fine with that. But why should I be responsible for covering a larger portion than a nonsmoker of state subsidized health care because of my lifestyle decisions. (Kingston Mariner, MA)
Temple University Physicians not renewing contract with Keystone Mercy Jul 24, 2008
Those patients with new conditions will also have the option of switching their coverage to another Medicaid HMO plan to continue to see their Temple physician. Representatives of Keystone Mercy, the region's largest Medicaid HMO plan, were not immediately available for comment. (Philadelphia Business Journal, PA)
Hewitt Associates: Southeast to see highest HMO rate jump Jul 20, 2008
HMO premium rates for the Southeast are expected to rise 15 ... After plan changes, negotiations and terminations, final average HMO rates in 2008 for the Southeast actually rose 9 ... Nationally, HMO premium rates are expected to increase 11. (Memphis Business Journal, TN)
Dennis Clayson Jul 16, 2008
But during Sophmore year, just before finals, his roommate and he get popped with a bag of weed in their dorm ... So our little abortion survivor leaves school and fortunately lands a job at a meatpacking plant where he starts at a robust $9 an hour and a less than stellar HMO plan making strategic cuts in cattle carcasses 10 hours a day, on his feet. (Waterloo-Cedar Falls Courier)
My testament to proper care Jul 16, 2008
Currently, HMO outpatient treatment covers up to 24 visits per calendar year. Children and adults who suffer from mental illness such as post-traumatic stress disorder are subject to this limit. (Boston Globe -- Editorial)
Trend away from HMOs has reformers concerned Jul 15, 2008
Between 10 percent and 11 percent of its recent enrollment has been in plans with "leaner designs," including high-deductible and HSA-compatible versions of its traditional HMO products, said Wade Overgaard, Kaiser's senior vice president for sales and account management ... "There continues to be a movement toward leaner-type benefit options," Overgaard said, "to offset some of the premiums and costs of health care." He said Kaiser sees the trend continuing, as HMO enrollment regionally takes a... (San Francisco Business Times, CA)
LETTERS: NCT, July 13, 2008 Jul 14, 2008
If you choose to be a lower paid worker, then plan to be in an HMO. So you took a different course, you'll probably be in the cash-only line. Like most of the wealthy do. (North County Times)
HEALTH BLOG: Easy to digest nutrition news briefs Jul 8, 2008
Fitness and nutrition - Better Life - USATODAY.com. Kids and cholesterol. (USA Today -- Money)
Medicare Advantage: An Even Earlier Demise? Jul 8, 2008
The program with the somewhat Orwellian name allows Medicare beneficiaries to opt for an HMO over the government plan. Though it's counterintuitive that a senior citizen would dump all-you-can-eat coverage from the government for an HMO that can deny or limit care--more than one in five beneficiaries have done just that ... The reason: Medicare HMOs have more money to spend because they get 12% more per member than the government pays under its conventional plan. (Forbes -- Business)
Calif. Ignores $1M Fine Of Health Insurer Jul 5, 2008
The state's Department of Managed Health Care is the only stand-alone HMO regulatory body in the country, and is tasked with ensuring fair practice for more than 21 million enrollees. MMVIII The Associated Press. (CBS News)
Calif didn't try to collect Anthem Blue Cross fine Jul 5, 2008
"To be able to defend the citizens of this state, I have to be able to win in court. I have to make sure that we have defensible positions and we're getting the wins we need for enrollees."The state's Department of Managed Health Care is the only stand-alone HMO regulatory body in the country, and is tasked with ensuring fair practice for more than 21 million enrollees. Comments. (Fresno Bee -- Business)
PNC to review implementation of NHIS Jul 4, 2008
He said: "The NHIS is currently being implemented on one leg, hence the teething problems associated with its administration but unfortunately the ruling New Patriotic Party (NPP) has failed to consult the initiators. "Under a PNC Government in January 2009, the other leg of the scheme known as Health Maintenance Organization (HMO) would be outdoored to give full complement to NHIS," Dr Mahama stated at the last in a series of an interactive platform dubbed; "An Evening Encounter With... (Ghana Web, Ghana)
Window is closing on Congress' ability to address Medicare cuts Jul 4, 2008
Herseth Sandlin contends the bill makes modest reforms to private, fee-for-service Medicare Advantage plans, not the HMO and PPO plans that are more common in South Dakota. Those reforms would save an expected 12 billion over five years. (Rapid City Journal, SD)
UnitedHealth cuts outlook, sheds 4,000 jobs Jul 3, 2008
United Health bought , the third-largest HMO and PPO in Greater Sacramento, based on Business Journal research. Share of UnitedHealth were trading at $26. (Sacramento Business Journal, CA)
Jon WertheimTENNIS MAILBAG Jul 3, 2008
She's in her mid-20s and has already required enough medical attention to bankrupt an HMO. She's had ankle and shoulder injuries and nasal surgery ... -- John Gibney, Richmond, Va. (SportsIllustrated.CNN)
JCMG celebrates 15 years of holistic healing (774) Jul 2, 2008
At that time unlike any time in previous central Missouri history HMOs were sought after by employers, especially the state ... gofish wrote on Jun 30, 2008 8:51 AM:" The health care community always cuts Medicaid coverage claiming that the reimbursement rates are too low. When I get my benefits statements and see what my HMO paid the provider, it seems to me to be an unreasonably high amount for the service I received. It's no secret that my HMO helps pay for the uninsured, account write-offs,... (Jefferson City News Tribune, MO)
30 comments Jul 1, 2008
Betrayed by the New York Times - HUMAN EVENTS. Betrayed by the New York Timesby Posted: 06/30/2008. (Human Events Online)
Staying Social May Keep Dementia at Bay Jun 27, 2008
For this new study, published in the July issue of the American Journal of Public Health, Crooks and her colleagues conducted telephone interviews with the women, all of who were members of the Kaiser Permanente HMO. The women were free of dementia when the study started in 2001. The team tested each woman's cognitive status by phone and reviewed her medical records to help assess it, as well. (Health-Finder)
Avoid the freshman fifteen this fall Jun 26, 2008
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Blue Shield of California Appoints Industry Veteran as New Vice President and General Manager for Senior Market Jun 25, 2008
In this new role, Stewart is responsible for providing strategic direction, business planning and overall leadership for the senior market lines of business, including Medicare Advantage HMO, Medicare Supplement and Medicare Part D Drug Plans. Kiner will report to Karen Vigil, senior vice president of Blue Shield's Individual, Small Group, and Government Business Unit. (PR Newswire)
Letters to the Editor (June 24) (54) Jun 25, 2008
And I'm not talking about HMO plans either. " CarpeDM wrote on Jun 24, 2008 5:48 PM:" A solar panel on a high rise would not have the square footage in size to handle the power requirements. (Corvallis Gazette Times, OR)
Readers' Platform: Treatment denied Jun 24, 2008
If your attorney can prove the HMO or insurer acted unreasonably according to the terms of the plan or policy, you might be entitled to punitive damages and payment of at least part of your attorney's fees by the insurer. Read your plan. (San Francisco Chronicle -- Business)
Medical care's state of denial Jun 24, 2008
Last year, the state's HMO Help Center received nearly 90,000 calls from consumers asking for help in resolving their health plan woes. About 7,000 Californians have taken advantage of third-party medical reviews since 2001, when the state Department of Managed Health Care started offering them. (San Francisco Chronicle)
Letters from readers Jun 21, 2008
- Perhaps one of the biggest drawbacks, the lack of co-payments and/or coinsurance on most HMO insurance plans. Socialized medicine will be a disaster in this country. (Florida Times-Union)
CalPERS signs off on health care premium increases Jun 20, 2008
Basic health maintenance organization (HMO) rates will rise not quite 6 ... Statewide, basic CalPERS HMO rates for 2009 will increase from 3. (Sacramento Business Journal, CA)
CalPERS bumps up 2009 rates average 4.3% Jun 20, 2008
The announcement follows negotiations with Kaiser Permanente and Blue Shield of California, which provide HMO plans to CalPERS members ... CalPERS members who have the Kaiser HMO and work for the state -- as well as retirees and their dependents -- will see an 8. (San Jose Business Journal)
CalPERS panel OKs new health benefits premiums Jun 19, 2008
Under the committee's recommendations, the monthly premium for a family using Blue Shield's "NetValue" HMO would be $1,161, a 3 ... CalPERS' HMO premium increases have ranged from a high of 18 percent in 2004 to 7 ... HMO premium increases. (San Francisco Chronicle -- Business)
When to tell your therapist goodbye Jun 19, 2008
Keris Myrick, 46, of Pasadena, California, found a therapist through her HMO. After just one session, Myrick says, "she told me everything was fine so she didn't need to see me anymore. But I was adamant that no, things weren't going well. I was having feelings of sadness and was anxious, withdrawing, keeping all the blinds closed, but I guess she thought I was all right.". Many patients with chronic depression hope to keep their relationship with their therapist for as long as possible. (CNN)
Post a comment » Jun 19, 2008
x-Navy wrote on Nov 14, 2007 9:55 PM:" I have a few questions that I have yet to make sense out of. Since when does not supporting the war mean that you're not supporting your troops? How does supporting the war, and voting to keep soldiers and sailors on the danger line so they can return to an inadequate HMO health care regulated system that will not provide proper treatment equate to supporting the troops? Where does the funding come from, who will be owed, and what does that mean for future... (Canton Daily Ledger, IL)
CalPERS HMO rate increases lowest in 10 years Jun 19, 2008
Statewide, basic HMO rates for 2009 will increase from 3 ... The average overall HMO rate increase last year was 7. (San Jose Business Journal)
NY’s First Lady urges Hawthorne Valley grads to follow their dreams Jun 15, 2008
The chalk circle will be drawn in front of you, said New York s First Lady, a health care management expert at the Health Insurance Plan of New York HMO. Will you pull hard or let go. The graduation ceremony was conducted in the Hudson Middle School auditorium. (Hudson Register Star, NY)
Kaiser to test linking health records to Microsoft Jun 13, 2008
The test will initially be limited to Kaiser employees who volunteer to have their records transferred, but access could be widened to the HMO's 8 ... "People today do a lot of things for their health outside of a formal healthcare system," Silvestre said, adding that the HMO is looking for ways to help members improve their health outcomes. (Reuters)
Revisions to proposed teachers contract urged Jun 11, 2008
The GIC offers health care options such as HMO s, a dental and vision plan, long-term disability coverage, pharmacy benefits, and life insurance. Coverage to employees would be available under the GIC through Fallon Community Health, Harvard Pilgrim, Health New England, and Navigator by Tufts Health Plan. (Weymouth News, MA)
Reimbursement climate has HMOs feeling fiscally healthy Jun 10, 2008
The state's 38 HMOs posted a combined $642 ... 3 million from 37 HMOs in 2006, according to a report from the ... While total HMO enrollment in the state dropped 5. (Tampa Bay Business Journal, FL)
Hill Physicians reports final 2007 results, including $440M in revenue Jun 7, 2008
The group handles HMO contracting and other administrative functions for hundreds of small medical practices in a broad swathe of Northern California, including the Bay Area, the Sacramento region and much of the San Joaquin Valley ... Hill is one of the region's and the nation's largest IPAs, and has long been seen as a leader in HMO-style managed health care. (San Francisco Business Journal)
Breast Cancer Gene Risk May Be Overstated Jun 2, 2008
And even more good news my HMO paid for it. I would like to comment on a few of the earlier posts regarding prevention of cancer in the first place. (Yahoo News -- Cancer)
MDwise Enrollment Exceeds 300,000 Members May 31, 2008
After becoming licensed as an HMO in January of 2007 and securing a new state contract, MDwise now provides services to members of Indiana's Care Select program and Healthy Indiana Plan, in addition to Hoosier Healthwise. Both have attributed to the company's recent growth. (PR Newswire)
A day for seniors May 30, 2008
The brochures were about various health issues including health care for veterans, heart disease in women, HMO guides, smoking and menopause. She said their booth had seen quite a few visitors. (Lodi News Sentinel, CA)
HSA or HRA: Which is better for your company, employees? May 28, 2008
And millions of penny-pinching consumers are more likely to get a handle on runaway health care costs than even a small army of HMO or government bureaucrats. But despite these favorable attributes, the dilemma created by HSAs for employers quickly becomes apparent when they sit down and begin poring over the cost/benefit spreadsheets now being produced by brokers. (Denver Business Journal, CO)
To love, honor, obey and last May 24, 2008
Joe was in grad school and had no money, and I was working at an entry-level position for an HMO making just a little more than nothing, but I had good health insurance. Our wedding was beautiful on a very small scale. (Winona Daily News, MN)
Seniors trek to healthy fitness May 23, 2008
The title of her talk is You are your own HMO. She will also discuss the benefits of exercise. National Senior Health and Fitness Day is the Wednesday in may and it is the largest annual health promotion event for older adults who wish to remain active into their golden years. (Grants Cibola County Beacon, NM)
State has mismanaged payments for Medicaid May 21, 2008
Amy Redding wrote on May 19, 2008 11:37 PM:" Pretty soon no one will be abke to access medical care. A large percentage of Americans have no medical insurance because they are unemployed, work as temporary workers, or work for companies that do not provide medical benefits. These are those Americans who are able to work. Then there are the elderly, those with medical conditions that prevent employment, as well as people who rely on Medicaid. None of these people are at fault for not having... (DeKalb Daily Chronicle, IL)