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GLG News by Managed Care Experts

Analysis of: The New Insurance Frontier (www.healthleadersmedia.com)
    MiniMed aka Limited Medical aka Scheduled Medical Benefits are not new.  They derive from the disease specific plans of old.  The article suggests that the uninsured have been ignored which is incorrect.  Many major players have rushed this market niche to find...
David Zimmerman, PharmD, President/Owner
Doctors of Pharmacy, Inc.
Analysis of: Cialis Is Cleared for Daily Use (online.wsj.com)
    Physicians have been prescribing lower dose Cialis...off label... for a long time. The FDA finally agreed and approved it.
Analysis of: Outsourced Wombs (warner.blogs.nytimes.com)
Wombs for rent and organs for purchase is not new news, but it certainly is a growing business.  Aside from the obvious effect on a reinsurer profits for allowing very expensive transplanted vessels to be eligible for reimbursement, there is the larger issue of if it is right to allow. ...
Analysis of: To your health: diagnosing the state of healthcare and the global private medical insurance industry (www.swissre.com)
The authors comments are accurate for a multibillion dollar multinational reinsurer looking down from 30,000 feet.  The US spends about $1.6 of the estimated $5 billion.  Identifying emerging trends in foreign lands will take a wary eye.  It is highly unlikely that the type of risk giant...
Ronald Kiima, CPA, President
Ronald Kiima, CPA, President
Kiima Incorporated
Analysis of: Securities Suits Spike in 2007 (www.cfo.com)
The subject article provides some interesting insights into the upward reversal in the number of securities class-action lawsuits filed during 2007.  Given such, I thought it might be fitting to offer my personal insights into what I continue to believe is the most common, yet rarely noticed, accounting...
Richard Baland, Partner
Richard Baland, Partner
B2B CFO
Analysis of: Medicare | Some Hospices Forced To Repay Medicare for Exceeding Reimbursement Limits as Patients Live Longer Than Expected (www.kaisernetwork.org)
The government has paid hundreds of millions less as a result of these measures. Now, the government has targeted the Hospice industry. Of course, there is no physician that can predict how long a patient will live. Physicians sign orders for Hospice patients that are terminal. The physician cannot...
Richard Baland, Partner
Richard Baland, Partner
B2B CFO
Analysis of: Crouse Hospital's Turnaround Shows There's Hope For Distressed Hospitals (www.hfma.org)
Board restructuring, Implementation of appropriate information systems, Productivity and staffing, Debt restructuring, Revenue cycle improvements, Supply expense reductions, New contracts and capital equipment approval processes are the Turnaround areas that scorecards...
Frederic Goldstein, President and Chief Operating Officer
Frederic Goldstein, President and Chief Operating Officer
U.S. Preventive Medicine, Inc.
Analysis of: CBO: Medicare and Medicaid spending growth unsustainable (www.ama-assn.org)
While Medicare and and Medicaid currently consume about 8% of the countries GDP, the CBO projects these two programs will consume 18.5% unless major changes are made. These changes are going to require a much different approach than what is operating today.
Frederic Goldstein, President and Chief Operating Officer
Frederic Goldstein, President and Chief Operating Officer
U.S. Preventive Medicine, Inc.
Analysis of: Form 8-K for HEALTHWAYS, INC (biz.yahoo.com)
The current standard approach to disease management does not work well in the high disease burden, senior based market.  For DM to be successful with these populations they must provide more intensity of services. While this cancelation by CIGNA of the contract will not impact Healthways as they...
Frederic Goldstein, President and Chief Operating Officer
Frederic Goldstein, President and Chief Operating Officer
U.S. Preventive Medicine, Inc.
Analysis of: Stiffer penalties on shoddy nursing homes sought (www.reuters.com)
The nursing home industry has been an arena for investors to establish large companies and then sell them at a profit. Although regulated now, the industry is in for additional scrutiny based on investigations and Committee hearings.

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