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    News, Reviews, and Articles on Managed Care

    Archives: Managed Care

    ADHD medication VYVANSE now available in 6 dosage strengths at US pharmacies  Aug 27, 2008
    VYVANSE formulary coverage has been positive; the top six managed care plans now cover the product in a preferred formulary position, and as of June 30, 2008, Shire has executed agreements with nine of the top 11 managed care organizations. At a national level, more than 92 percent of VYVANSE prescriptions are approved without restrictions (which means without requiring any additional steps from the doctor or patient), and VYVANSE has a competitive copay among covered formulary plans. (EurekAlert! -- Business News)

    Doctor accuses Roxon of move to 'American-style' benchmarking  Aug 27, 2008
    THE planned disclosure of private hospitals' record on safety and quality has been decried by the medical leader Rosanna Capolingua as a step towards "American-style managed care" that would put costs before patients ... "The Government has no plans to introduce managed care. Introducing strong performance measures will help deliver better accountability, and drive competition and innovation," the spokesman said. (Sydney Morning Herald -- Australia)

    New Jersey Physicians Band Together for Savings: Group Purchasing Promises Discounts to Doctors  Aug 26, 2008
    TRENTON, N.J., Aug. 25 /PRNewswire/ -- Squeezed by managed care companies at one end and an economic downturn at the other, New Jersey's doctors are banding together as small business owners to save money on supplies and services. NJ Physicians ), an association of New Jersey medical doctors, announced the creation of a wide-ranging purchasing alliance today which will give doctors discounts on everything from children's vaccines to copy paper. (PR Newswire)

    Health care stocks performing well  Aug 26, 2008
    Investors have long fretted about the ability of big pharmaceutical makers to replace blockbuster drugs losing patent protection and what would happen to drug and managed care companies if a Democratic president teamed up with a Democratic Congress and got serious about reining in medical costs. While those fears remain, they are taking a backseat to worries about housing, energy, the financial system and geopolitics. (San Francisco Chronicle -- Business)

    Healthways Suffers  Aug 26, 2008
    "Unfortunately, in an environment in which medical costs continue to rise and managed care and corporate executives scrutinize expenses and minimize discretionary investments, we think Healthways' high-priced services stand to lose ground," Jeffries analyst Arthur Henderson said. "Should management opt to reduce prices to compete more effectively, it will likely be at the expense of margins and earnings.". (Forbes -- Markets)

    No Prescription? Have Some of Mine  Aug 26, 2008
    It would take too much time in the assembly line of managed care. Posted by Janet. (New York Times)

    Hanger Orthopedic Group, Inc. Files Replacement Shelf Registration Statement  Aug 23, 2008
    However, various risks, uncertainties and contingencies could cause actual results or performance to differ materially from those expressed in, or implied by, these statements, including the Company's ability to enter into and derive benefits from managed care contracts, the demand for the Company's orthotic and prosthetic services and products and the other factors identified in the Company's periodic reports on Form 10-K and Form 10-Q filed with the Securities and Exchange Commission under the... (PR Newswire)

    Alpharma Shares Undermined by Medco as Insurers Balk at Pain-Patch Payment  Aug 22, 2008
    Managed care is starting to push back'' on the product, Sanderson said in a telephone interview. As a result, ``physicians are becoming more reluctant to prescribe it than they were two months ago. (Bloomberg)

    Bill may aid licensing for surgery centers  Aug 22, 2008
    After licenses lapse, many centers have sought accreditation from a private accrediting body, , to keep in good standing with managed care. According to O Dell, who is working on opening some new centers, the number of centers seeking accreditation from the Illinois company has also made for a shortage of inspectors, which is delaying the opening of some of his centers. (East Bay Business Times, CA)

    Poison Center has all the answers  Aug 21, 2008
    But with no revenue and "managed care" and consolidation taking hold among Iowa's belt-tightening hospitals, the state's poison centers started to disappear, whittled down to the final two, Kalin said. In 1996, St. Luke's became an affiliate of Iowa Health System. (Sioux City Journal, IO)

    Peritoneal Dialysis Nurse  Aug 21, 2008
    Healthcare - Health Services Managed Care. Manages Others. (Florida Today)

    Panel calls for freeze of Charter Oak enrollment  Aug 21, 2008
    HARTFORD The Medicaid Managed Care Council unanimously recommended Wednesday that the state freeze enrollment in the fledgling Charter Oak insurance plan and keep Husky insurance as presently constituted until the end of the fiscal year ... DSS is beginning the transition to the new managed care organizations as of Sept. 1, starting with Middlesex County, where the newest insurers, Americhoice and Aetna Better Health, are just beginning to put together provider networks ... This compares to... (New Haven Register, CT)

    SF Health Plan appoints new medical director  Aug 20, 2008
    In March, of Foster City hired Swati Awsare, the San Francisco plan s former medical director, as chief medical officer at the managed care software and physician group management company. An interim director had filled in since then. (San Francisco Business Times, CA)

    Indiana, nation brace for doctor shortage (34)  Aug 20, 2008
    thats what you get wrote on Aug 17, 2008 7:22 AM:" Doctors experienced the huge amount of red tape involved with treating managed care patients. Patients often don't get the proper care because someone sitting 1500 miles away in a nice office is telling them what they can or cannot do for their patient. Managed care also capped the amount of money they can make. Increasing lawsuits with high premiums of 10s of thousands of dollars forced out many ob/gyns. Now Obama wants universal healthcare.... (Munster Times, IN)

    Schwarzenegger's push to hike sales tax riles GOP  Aug 20, 2008
    Snyder did not reverse cuts for managed care programs and some hospitals, saying there was no proof that their care would be compromised. Lisa Page, a spokeswoman for Schwarzenegger, said Tuesday that the administration was reviewing Tuesday's ruling and determining next steps. (Los Angeles Times)

    Seton makes changes in executive staff  Aug 19, 2008
    Seton also has a new senior vice president of Managed Care, Chris Hartle ... Hartle has been with Seton since 1994, and has been responsible for negotiating Seton Managed Care contracts and directing Seton's strategic pricing. (Austin Business Journal, TX)

    Medicaid probe at WellCare Health Plans leads to $32.5 million payment  Aug 19, 2008
    WellCare (NYSE: WCG), which provides managed care services for government-sponsored health care plans, disclosed July 21 that it had found accounting errors related to contracts with AHCA, the and the Illinois Department of Health and Family Services. The company said it owed as much as $46. (Tampa Bay Business Journal, FL)

    Health-care providers brace for Medicaid cuts  Aug 18, 2008
    5 million), programs such as Medicaid Managed Care and Family Health Plus, long-term care premiums and early-intervention providers delivering non-Medicaid services. Health-care executives say though the cuts may help lower the deficit in Albany, in the long run, the cuts will mean increased costs and diminished services for all consumers, not just those who are Medicaid eligible. (Buffalo Business First, NY)

    Taking away pain  Aug 17, 2008
    The difficult aspect -- the part I don't like about being a chiropractor -- is dealing with managed care programs. I have to do reports and request treatment authorizations. (Fresno Bee -- Lifestyle)

    RN Location Director  Aug 15, 2008
    Industry:Healthcare - Health Services Managed Care. Manages Others:Yes. (Florida Today)

    WellCare discloses pay package for chief compliance officer  Aug 15, 2008
    Rich was general counsel and chief compliance officer for health insurer He is one of several executives named to a revamped management team at WellCare (NYSE: WCG), a provider of managed care services for government-sponsored health care plans, following the Oct. 24 raid on the company s Tampa headquarters by state and local agencies. The exact nature of the government probe remains unspecified. (Tampa Bay Business Journal, FL)

    WellCare membership shift expected to push profit down  Aug 14, 2008
    WellCare (NYSE: WCG), which provides managed care services for government sponsored health care plans, has been under investigation since an Oct. 24 raid by federal and state agencies at its Tampa headquarters. Last month the company said it had determined that it would have to for 2004, 2005, 2006 and the first half of 2007, based on the identification of issues by a special committee of its board. (Tampa Bay Business Journal, FL)

    Amil Exceeds the 3 Million Member Mark, Net Income Moves Up 56% in 2Q08  Aug 13, 2008
    SA), the largest managed care organization in Brazil, announced today its consolidated results for the second quarter 2008 ... To access the full version of the earnings release, visit our website at Upcoming Events: Conference Calls English August 13, 2008 (Wednesday) 11:00 AM (New York) 12:00 Noon (Brasilia) Phone: +1 (412) 858-4600 Code: Amil Replay: +1 (412) 317-0088 Code: 6092# Portuguese August 13, 2008 (Wednesday) 2:00 PM (New York) 3:00 PM (Brasilia) Phone: +55 (11) 4688-6301 Code:Amil... (PR Newswire)

    HearUSA reports Q2 revenue up 21%  Aug 13, 2008
    The West Palm Beach-based company (AMEX: EAR) is a leader in hearing care for the nation s top managed care providers through more than 190 company-owned hearing care centers and a network of over 1,900 affiliated providers. Net income applicable to common stockholders totaled $245,000 or a penny a share. (South Florida Business Journal, FL)

    Drug companies balk at governor's move  Aug 12, 2008
    Codifying the Code takes away the flexibility to update compliance programs as needed to comply with various federal laws and regulations as well as changes in managed care and other areas of health care, he said. PhRMA said it will focus now on trying to make sure regulators hash out policies that don t impede research or force pharmaceutical companies to reveal competitive information. (Boston Business Journal, MA)

    NHC buys two S.C. facilities for $13.25M  Aug 12, 2008
    NHC's other services include managed care specialty medical units, Alzheimer's units, hospice and a rehabilitation services company. "The superior quality of NHC's services to the senior care community in the state of South Carolina is well known," says Steve Flatt NHC's senior vice president of development. (Nashville Business Journal, TN)

    Doctors Hospital, Genesis join to combat managed care  Aug 12, 2008
    in Lanham is linking up with long-term care provider Genesis Health Ventures to blunt the impact of managed care ... Smaller, community-based providers are having problems competing with larger hospital systems that attract the bulk of managed care contracts ... "Doctors Hospital, like many other hospitals today, is very much looking to diversify and increase services to be as attractive to managed care," said Doctors Hospital chief executive Phil Downs. (Washington Business Journal, DC)

    Novis Pharmaceuticals Announces John W. Kilgour as Executive Vice-President of Sales & Marketing  Aug 11, 2008
    Other key positions within Cardinal Health included sales management to national and regional Group Purchasing Organizations (GPOs) as well as managing pharmaceutical and medical supply sales and marketing initiatives for the acute care and managed care business segments. Tom Burke, President and CEO of Novis Pharmaceuticals, said, "John will be a great mentor and teacher for our employees and an even better advocate for our customers. He has established longstanding, solid relationships and has... (PR Newswire)

    Psychiatrists Shift Away From Providing Psychotherapy  Aug 11, 2008
    "This decline coincided with changes in reimbursement, increases in managed care and growth in the prescription of medications," the authors write ... "A key challenge facing the future generation of psychiatrists will likely involve maintaining their professional role as integrators of the biological and psychosocial perspectives while working within the constraints of the strong market forces of third-party payers and managed care to implement advances in the diagnosis and treatment of mental... (Science Daily)

    Centers wary of Charter Oak plan  Aug 10, 2008
    Charter Oak, along with the state's existing Husky insurance for children and their families, is being implemented by three managed care companies that submitted bids to the state Department of Social Services earlier this year - Community Health Network, Aetna Better Health and Americhoice ... Lawrence Cross,executive director of the Norwalk Community Health Center, said that under previous state programs the centers had to submit patients' claims to the managed care companies, then seek the... (Norwalk Advocate)

    Letters for Sunday, August 10, 2008  Aug 10, 2008
    Also, Next February, DHS will begin QUEST Expanded Access which will improve the health of our seniors and disabled Medicaid clients by providing them with a comprehensive and coordinated system of managed care. Jill Cooper, policy analyst Office of the Governor. (Lihue Garden Island, HA)

    PD-Rx Completes Call for Preferred A Stock  Aug 9, 2008
    Our goal is to develop a matrix of cost containment tools and products that we can merge into any healthcare network to enhance patient care and improve managed care organizations bottom line. We provide proprietary products and prepackaged medications that are viewed by patient, insurance payers and healthcare providers as a progressive and responsive practice. (PR Newswire)

    California Democrats push bills to fight spread of autism  Aug 8, 2008
    SB 1563 would direct the state Department of Managed Care and Department of Insurance to work to ensure that health plans and insurers provide equitable coverage for autism and other developmental disabilities. Sen. (Yahoo News -- Autism)

    WellCare names William White chief accounting officer  Aug 8, 2008
    WellCare (NYSE: WCG), a managed care provider based in Tampa that serves government sponsored health care plans, has had a turnover in top executives since an Oct. 24 raid by federal and state law enforcement officials. The exact nature of the government probe remains unspecified. (Tampa Bay Business Journal, FL)

    Tobin to lead Centene headquarters project  Aug 8, 2008
    St. Louis-based (NYSE: CNC) provides managed care programs and related services to individuals under Medicaid. It also operates health plans in Georgia, Indiana, New Jersey, Ohio, Texas and Wisconsin. (St. Louis Business Journal, MO)

    Insurance Giant Leverages Technology to Enhance Offerings  Aug 7, 2008
    Aug. 5 /PRNewswire/ -- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that Health Care Service Corporation is utilizing enterprise-wide technology-based initiatives to increase efficiency and serve its members ... 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... (PR Newswire)

    Mount Carmel deal with managed-care provider hangs in balance  Aug 7, 2008
    John Kontner, OhioHealth s system vice president of managed care, said the hospital operator was open to discussing reimbursement rates with CareSource rates he said were deemed too high at the time but the provider gave an ultimatum on rates. When both sides got to the bargaining table three months ago, a termination letter had been issued for OhioHealth and talks were unsuccessful, he said. (Columbus Business First, OH)

    SXC Health Solutions announces second quarter financial results  Aug 7, 2008
    QUICK SEARCH BY ORGANIZATION. FREE SUBSCRIPTION SERVICES. (Canada Newswire)

    Molina Healthcare to acquire Florida NetPass  Aug 7, 2008
    -based, managed care organization in five of the top 10 Medicaid markets in the country. Florida NetPass provides care management and administrative services to about 58,000 members in South and Central Florida. (South Florida Business Journal, FL)

    For Psychiatrists, Talk Therapy Falling by Wayside  Aug 7, 2008
    Study finds managed care, more medications have led psychiatrists to drop this approach ... The trend, noted by researchers publishing in the August issue of the Archives of General Psychiatry, appears to be due to fewer psychiatrists trained or specializing in psychotherapy and an increase in the number of drugs available, along with a reluctance by managed care to pay for psychotherapy ... "Thanks to the advances of managed care, psychotherapy was basically devalued from the perspective of... (MEDLINEplus)

    Psychiatrists go for pill power  Aug 6, 2008
    The shift to briefer visits for medication management appears to be linked to better psychiatric drugs and pressure from managed care companies. "Psychiatrists get more for three, 15-minute medication management visits than for one 45 minute psychotherapy visit," said Dr Ramin Mojtabai of Johns Hopkins University in Baltimore. (India Times, India)

    HealthSouth Reports Strong Results for Second Quarter Ended June 30, 2008  Aug 6, 2008
    6% quarter-over-quarter increase in patient discharges, as well as an increase in net patient revenue per discharge due to a change in patient mix and favorable quarter-over-quarter reimbursement trends from managed care payors ... 4 % Managed care and other discount plans 19. (PR Newswire)

    People and Places (July 31, 2008)  Aug 6, 2008
    She is also responsible for managed care contracting and relations. Robert White, now assistant vice president of support services, will oversee the environmental services, food services and transporters in addition to his previous duties which included responsibility for supply chain management, sterile processing and distribution, and campus security. (Carroll County Times)

    UPDATING: American Independence Corp. (AMIC) Chief Executive Officer to Ring the NASDAQ Stock Market Closing Bell  Aug 6, 2008
    org, LLC. AMIC markets medical stop-loss, small group major medical, and managed care insurance and reinsurance through managing general underwriters, including IndependenceCare, Marlton Risk Group, and Risk Assessment Strategies. Source: The NASDAQ OMX Group, Inc.. (Primezone Releases)

    Gentiva(R) Health Services Strengthens South Carolina Home Health Operations With Acquisition Covering Three CON Counties  Aug 5, 2008
    The Company serves patients across the United States, through its direct service delivery units or through CareCentrix(R), which manages home health services for major managed care organizations. Gentiva is a single source for skilled nursing; physical, occupational, speech and neurorehabilitation services; hospice services; social work; nutrition; disease management education; help with daily living activities; respiratory therapy and home medical equipment; infusion therapy services; and other... (PR Newswire)

    Humana's Results Lift Managed Care Sector  Aug 5, 2008
    81 and lifted shares of managed care companies Monday ... As a result, managed care companies may have to raise premiums and scale back benefits, making the plans less appealing to employers and recipients ... Medicare Advantage has been a main growth driver for Humana and other managed care providers. (Forbes -- Markets)

    Charter Oak health plan threatened  Aug 5, 2008
    At Norwalk Hospital, Karen Staff, director of managed care said administrators are "reviewing the plans from a legal, financial and occupational/service perspective. "We really need to complete our analysis and make recommendations to our senior administrators before making any [public] statements," Staff said. At Danbury Hospital, spokeswoman Andrea Rynn said the "hospital's door is always open" to negotiations with the Charter Oak Health Plans. "Philosophically, we believe in the importance of... (Connecticut Post)

    Pills taking over from psychotherapy  Aug 5, 2008
    The shift to briefer visits for medication management, reported in the Archives of General Psychiatry, appears to be linked to better psychiatric drugs and pressure from managed care companies, which offer richer financial incentives for brief office visits. "Psychiatrists get more for three, 15-minute medication management visits than for one 45 minute psychotherapy visit," said Dr. Ramin Mojtabai of Johns Hopkins University in Baltimore and formerly of Beth Israel Medical Center in New York,... (Globe and Mail)

    Media Advisory - BMO Capital Markets to Host 8th Annual Focus On Healthcare Conference  Aug 4, 2008
    The team includes: Christine Charette (Biotechnology, Canada); Erik Chiprich (Healthcare Facilities); Robert Hazlett (Pharmaceuticals); Dave Shove (Managed Care and Benefits); Joanne Wuensch (Medical Technology); and Jason Zhang (Biotechnology, U.S.). About BMO Capital Markets BMO Capital Markets is a leading full-service North American financial services provider, with 2,400 employees operating in 14 North American offices and 26 worldwide, offering corporate, institutional and government... (Canada Newswire)

    From Within Charter Oak Effort, Appeal To Go Slow  Aug 4, 2008
    com ]Monday, Aug 4, 2008. Commissioner told Rell's office of doubts about starting health plan before doctors, hospitals sign on. (TheDay)

    E-mails show Charter Oak push (7:19 a.m.)  Aug 4, 2008
    "Lisa, I am pushing as fast as I can on this but I am sure you agree that the last thing we want is for us to start the program and the managed care companies not have their network of providers signed up," he wrote. "I know we want to open as soon as possible with a splash and press coverage, but all the pieces have to be in place," Starkowski added. (New Haven Register, CT)

    Hospital profits rise 17 percent  Aug 4, 2008
    South Florida hospitals are limited by the strong negotiating power of managed care plans here. This article is for Paid Print Subscribers ONLY.. (South Florida Business Journal, FL)

    Could Philly hospital tax work here?  Aug 4, 2008
    She said there is precedent for such an assessment, which exists for nursing homes, managed care organizations and facilities for the mentally retarded. "This is an accepted practice and brings federal dollars to strengthen the overall [health care] system," she said. (Pittsburgh Post-Gazette, PA)

    Costs rise 24% as few enroll in new health plan​  Aug 2, 2008
    Costs rise 24% as few enroll in new health plan By Mary E. O'Leary, Register Topics Editor08/02/2008 State contracts for the managed care organizations charged with administering health care for the poor and the new Charter Oak plan show a cost increase of 24 percent over last year, a boost legislative leaders feel is unjustified. Also, the low number of providers onboard has them asking what is the rush. (New Haven Register, CT)

    Health-care roundtable  Aug 1, 2008
    He previously served as vice president of research and product development at the company, which administers prescription drug plans for more than 50 million Americans through thousands of employers, managed care plans, governments and labor unions. Prior to joining Express Scripts, Miller spent six years as vice president and chief medical officer of Barnes-Jewish Hospital, the region's largest hospital. (St. Louis Business Journal, MO)

    WellCare names chief compliance officer  Jul 31, 2008
    WellCare, based in Tampa, provides managed care services for government-sponsored health care plans. WellCare's top executives resigned in January in the wake of a federal probe of the company. (Jacksonville Business Journal, FL)

    Our view: Prescription for reform  Jul 30, 2008
    Under former Governor Jeb Bush, the Legislature ran a five-county pilot program to shift Medicaid services for poor, elderly and disabled Floridians into managed care programs, which compete for patients and state fees. The goal was to slow the mushrooming costs of Medicaid and improve access to basic care -- a terrific idea, if it works. (Florida Today)

    Sink wants audit of WellCare payments to Florida Healthy Kids  Jul 28, 2008
    Sink's comments followed the disclosure by WellCare that it would for 2004, 2005, 2006 and the first half of 2007 since determining it owes refunds under contracts to provide managed care services for government health care programs in Florida and Illinois ... WellCare (NYSE: WCG), which provides managed care services for government-sponsored health care plans, has been under fire since an Oct. 24 raid by state and federal law enforcement authorities at its Tampa headquarters. (Tampa Bay Business Journal, FL)

    Health Partners Chooses Healthation's AboveHealth Provider Portal  Jul 26, 2008
    Over more than 20 years, Health Partners has garnered national attention for innovations in managed care, and now serves more than 140,000 members throughout southeastern Pennsylvania. Please visit us at. (PR Newswire)

    BioTrends Releases Quarterly TreatmentTrends(TM): Nephrology Report Highlighting Market Trends for Renal Anemia, Hyperphosphatemia, and Secondary Hyperparathyroidism  Jul 26, 2008
    And, approximately one-third of Nephrologists report that their ESA use has decreased specifically due to managed care policies. While there have been no significant changes in market share year over year (Amgen's Epogen remains the market leader in dialysis and Ortho Biotech's Procrit and Amgen's Aranesp continue to battle for market leader position in CKD), there are indicators of brand switching, particularly related to office stocking and managed care reimbursement. (PR Newswire)

    Find the money soon  Jul 25, 2008
    However, one that has been prominently mentioned - shifting more Medicaid members to managed care plans - seems unlikely to produce the immediate savings needed ... 1 million Medicaid members in managed care plans ... According to the Executive Office of Health and Human Services, managed care plans have historically served the healthiest Medicaid recipients but "have not yet demonstrated the capacity to serve large numbers of disabled members." The state is starting to bring in new plans with... (Boston Globe -- Editorial)

    High-level California health executives prefer Obama to McCain, survey says  Jul 25, 2008
    Participants represented California hospitals and systems; medical groups and IPAs; home health, imaging and dialysis companies; managed care and other insurance-related firms; medical device and diagnostics companies; pharmaceutical, biotech and drug discovery companies, and health care IT and health care-focused professional-services firms. "The diversity of the combined responses of the surveyed, top-level executives ... reflect(s) the complexity and the breadth of thinking on the core issues... (East Bay Business Times, CA)

    Coalition fights fee plan for insurers  Jul 24, 2008
    Urges alternative of mandatory managed care ... The coalition is pushing an alternative that would require all Massachusetts Medicaid patients to join managed care plans, which try to achieve savings in part by restricting patients' choice of providers and services ... The coalition says mandatory managed care would save the state $160 million this fiscal year and between $690 million and $1 billion by 2013. (Boston Globe)

    Referrals to Western Psych halted  Jul 24, 2008
    The temporary moratorium will affect new referrals for Medicaid recipients covered by the state's HealthChoices behavioral health managed care program, as well as patients leaving Mayview as part of the planned closure of the facility by the end of this year, state officials said. Those referrals will instead be sent to other local providers of community mental health services, officials said. (Pittsburgh Post-Gazette, PA)

    UnitedHealth Profit Drops but Tops Estimates  Jul 23, 2008
    "The worst case didn't happen to managed care, and that was enough for people to jump back in," said analyst Les Funtleyder of Miller Tabak The assumption is the worst is over. " UnitedHealth's net income fell to $337 million, or 27 cents per share, from $1.23 billion, or 89 cents per share, a year ago. Hefty lawsuit settlements and thinner margins in its health care services business contributed to the profit drop. Tough economic conditions, including a competitive industry that's seeing fewer... (ABC News -- Wire)

    U.S. Federal Circuit Court of Appeals Fully Upholds Eisai's Favorable Ruling in Aciphex(R) Patent Infringement Lawsuit Against Teva Pharmaceuticals and Dr. Reddy's Laboratories  Jul 22, 2008
    Product risks and uncertainties include, but are not limited to, technological advances and patents attained by competitors; challenges inherent in new product development, including claims and concerns about product safety and efficacy; domestic and foreign healthcare reforms; trends toward managed care and healthcare cost containment; and governmental laws and regulations affecting domestic and foreign operations. Also, there are manufacturing and marketing risks and uncertainties, which... (PR Newswire)

    Physician hospitals struggle with contracts  Jul 22, 2008
    Laura Comer, vice president of managed care, says it took the hospital two years to get its first contract with a major insurer. Comer would not disclose the insurer, but says the deal was signed in April. (Houston Business Journal, TX)

    Daily Briefing  Jul 22, 2008
    WellCare Health Plans Inc., the U.S. managed care provider being investigated over possible fraud, said it will restate earnings going back to 2004. The Tampa-based provider of government-backed health plans for the elderly and the poor will revise calculations in several areas, according to a filing with the Securities and Exchange Commission. (Atlanta Journal-Constitution -- Business)

    UnitedHealth 2Q profit falls on charges, tops view  Jul 22, 2008
    Managed care provider UnitedHealth Group has reported a sharp drop in second-quarter profit, due to hefty lawsuit settlements, but adjusted results topped Wall Street expectations. The Minneapolis-based health insurer also reaffirmed its outlook for the full year. (ABC 7 News, DC)

    UnitedHealth Group 2Q net earnings down 73 percent  Jul 22, 2008
    Its local operations are based in West Chester, and it has about 440,000 Greater Cincinnati enrollees in its managed care plans. Reader Comments. (Cincinnati Business Courier, OH)

    Insurance Cancellation Questions Could Spread Beyond California  Jul 21, 2008
    More regulations & laws are needed to manage MANAGED CARE insurance companies. Some areas that need to be addressed are self-referrals within insurance companies, coverage/service denials, premium caps, minimums on coverage limits, cancellation & coverage change timeline control and administrative costs (control caps). (Wall Street Journal Blogs)

    Qtrac Software and Patient Placement Systems Announce Partnership and Healthcare Data Interface  Jul 18, 2008
    Through this partnership, Patient Placement Systems will connect disparate referral, admissions and discharge databases with Qtrac's clinical care applications to streamline communication, transfer of data and enable new residents to be quickly and efficiently transitioned into a managed care delivery model with supporting documentation. Daphne Clark, president of Qtrac Software, said, "Patient Placement Systems software is recognized as an industry leader for patient referral automation... (Yahoo News -- Press Releases)

    Judge: Key Ford witness does not have to testify  Jul 17, 2008
    He also asked if Howard would answer questions about Managed Care Services Group, a consulting group that Ford and Howard were in together. "If I were to ask you questions in that regard, would you answer those questions?" Gant asked. (Chippewa Falls Chippewa Herald, WI)

    American Optometric Association Applauds Override of Medicare Cuts  Jul 16, 2008
    6 percent cut in Medicare payments to physicians and managed care plans and halts misguided new regulations governing durable medical equipment (DME) accreditation. "Congress heard us loud and clear. Massive Medicare cuts would have severely hampered our mission to ensure that America's seniors have access to quality and affordable eye care. I'm proud of the role that optometry played in averting a Medicare meltdown and protecting patient access to care," said Dr. Peter Kehoe, O.D., AOA... (PR Newswire)

    SA's non-healthcare costs world's highest  Jul 16, 2008
    " According to the 2006/07 annual report of the Council for Medical Schemes (CMS), the non-healthcare costs bill rose 3.7 percent to R8.3 billion. The figure comprises administration, net reinsurance, own facility costs, broker fees, managed care, trustee remuneration and bad debt. McLeod said the costs had risen from about R20 per member per month in 1974 to about R240 in 2006. In 2006 the average gross administration expenses for open schemes were R78 per beneficiary per month. For restricted... (Business Report, South Africa)

    Michael Thibdeau Named Chief Information Officer Of HVHC Inc.  Jul 15, 2008
    Prior to Davis Vision, Thibdeau was an executive vice president for Novalis Corporation, a managed care technology and consulting company and second vice president with Lincoln National Corporation's Employee Benefits Division in Fort Wayne, Indiana. Thibdeau also has worked in the health insurance and managed health care arena as vice president of financial services of the Albany, New York division of Empire BlueCross Blue Shield, and was a vice president and chief financial officer for Blue... (PR Newswire)

    League of Women Voters seeks more registration opportunities for voters  Jul 15, 2008
    Part of the reason for the resolution is its very hard for people in managed care residences, like assisted living facilities, to get out and go to register to vote, said Amy Williamson, the league state president. Wyoming allows voters to register at the polls. (Gillette News-Record, WY)

    Grady CEO finalists called 'a good group'  Jul 15, 2008
    " Burfitt said he left over a difference of opinion about the future of the company. Personnel file Age: 59 Birthplace: Warren, Ohio. Current Position: Health care consultant; CEO of Centura Health in Colorado until December 2007 Education: Bachelor's degree, Youngstown State University; master's in business and hospital administration, University of Florida Experience: Chief operating officer, Inova Health System, Falls Church, Va., 2004-2005; senior vice president, operations, Southern States... (Atlanta Journal-Constitution -- Metro)

    Trend away from HMOs has reformers concerned  Jul 15, 2008
    Even , the mother ship for traditional managed care, is feeling the heat. 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. (San Francisco Business Times, CA)

    LETTERS: NCT, July 13, 2008  Jul 14, 2008
    There are also many doctors who have decided to pull out of managed care altogether and treat people on a cash-only basis to get out from the absurdity of insurance-controlled medicine ... your starting to get the hang of this, "On the other hand" @1:18 PM.Choices, and that's what we're really talking about here, is being able to make choices between doctors who have pull out of managed care, and treat people on a cash-only basis. (North County Times)

    Old-fashioned docs inspire new 'medical homes'  Jul 14, 2008
    While health maintenance organizations and managed care companies aimed for such coordination, many didn't pay doctors adequately for it, instead rewarding them financially for restricting care, says McGeeney. Under medical homes, he says, doctors won't prevent patients from seeing specialists or ordering tests. (USA Today)

    Healthcare that's the cat's meow  Jul 13, 2008
    I believe Old Cat gets better care because her veterinarian is paid by fee for service, while my care, which is provided by a wonderful and caring primary care physician, is paid for by managed care, which looks at how many patients are seen. I've often noted managed care takes the "care" out of healthcare. (Boston Globe)

    Surprising insights from the social sciences  Jul 13, 2008
    IN THIS ERA of managed care and high-tech medicine, it's hard to see where bedside manner fits into the healthcare system. Nevertheless, a team of researchers at the University of Wisconsin found evidence that physician empathy can indeed have a significant therapeutic effect. (Boston Globe)

    California Democrats push bills to fight spread of autism  Jul 13, 2008
    SB 1563 would direct the state Department of Managed Care and Department of Insurance to work to ensure that health plans and insurers provide equitable coverage for autism and other developmental disabilities. Sen. (Yahoo News -- Autism)

    Anthem Blue Cross to pay Calif. hospitals $11.8M  Jul 13, 2008
    "Hospitals took care of Blue Cross' patients, got authorizations, and then didn't get paid by Blue Cross for the care they provided," said Ditmar Grellmann, senior vice president of managed care and professional services for the California Hospital Association. The settlement resolves all rescissions dating back to 2001, Grellmann said. (CNNMoney.com)

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