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GLG News by Managed Care Experts

Analysis of: Guaranty Insurance Services Announces Acquisition (www.insurancenewsnet.com)
Good article, and method.  Growing an agency is quite challenging today.  Its always a good idea to tie the buying price to longevity of the book and create an incentive to keep current clients renewing during the transition.       The smaller agencies may actually...
Frederic Goldstein, President and Chief Operating Officer
Frederic Goldstein, President and Chief Operating Officer
U.S. Preventive Medicine, Inc.
Analysis of: UPDATE: UnitedHealth, GHI, HIP To Adopt Doctor-Ranking Model (money.cnn.com)
For those who think Physician Scorecards are meaningless or they are problematic and hope that these measurement tools will not come; here are more large plans, some of whom  are going to roll out nationally with these systems and they now have a stamp of approval.
Analysis of: Should Doctors Own Hospitals? (www.businessweek.com)
Many risk assuming entities are available to doctors and hospitals courageous enough to believe they have the talent to manage their local healthcare market. Some 10-12 years ago we saw the market go nuts for Physician Practice Medical Groups (PPMGs), Group Practices without walls (GPWW’s), Independent...
Richard Baland, Partner
Richard Baland, Partner
B2B CFO
Analysis of: Improving Emergency Department Copay Collection (wiki.hmccentral.com)
The first step is to find out what copays are in the Emergency Room. A simple Excel spreadsheet needs to be developed showing what Medicare, Medicaid, Commercial insurance and managed care companies require as a copay. The second step is to communicate to the Admissions department, insurance department;...
Analysis of: New Urgency in Debating Health Care (www.nytimes.com)
     The market response to healthcare inflation running at 200%-300% of the rest of the economy will force federal action to fund care as an established precedent and "access" to care. We have surpassed the price point where many individuals and small employers now elect not to...
Robert Forster, MD, Healthcare Consultant
Robert Forster, MD, Healthcare Consultant
Robert Forster, MD
Analysis of: Cigna reaches deal on doctors' rankings (news.yahoo.com)
Fred is both right and wrong by history.  Ranking of physician performance is akin to work (or payment) for performance.  Since I was around at the beginning of this movement and watching its development, it is clear that work efficiency particularly will high acuity patients is very difficult...
Analysis of: American's Gamble for Bargain Surgery Abroad (www.medpagetoday.com)
The deals abound for care abroad.  The perceived risk is always of infection or complications a long way from home.  But the tremendous differences between costs for dental work, to lithotripsy, to plastic surgery attract the medical tourist for many procedures.  Where complex...
Analysis of: Bush vetoes bill on children's health care (www.reuters.com)
    Public policy is clearly moving towards more transparency of medical cost and outcomes. All the leading democratic candidates say that national health care is part of their agenda. Bush has relented from his veto position, and is considering lowering the poverty level for increased...
Richard Baland, Partner
Richard Baland, Partner
B2B CFO
November 7, 2007
Swing Bed Strategy
Analysis of: The Swing-Bed (www.rwjf.org)
Some hospitals review swing bed utilization as follows: 1)Initial review within 24 hours to see if inpatient criteria are met. Criteria incorporate Severity of illness and Intensity of Service. Severity of Illness can be shortness of breath, multiple effusions or other symptoms. In other words, the...
Richard Baland, Partner
Richard Baland, Partner
B2B CFO
Analysis of: Universal Health Coverage Attracts New Support (www.washingtonpost.com)
The Health insurance industry is anticipating a profit windfall with the Universal Health Coverage proposals. Where is that money coming from? Will it come from the Federal government? Or, will the money come from a segment of society that has less influence on this debate? Could it be that the industries...

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