GLG News by Managed Care Experts

  Dr. Parish has a rather shortsighted view of the role of third party administrators in general and appears not to appreciate their intended role in our "system." Both Cost and Quality have and are suffering from the "stepping back" and demonization of HMOs by stakeholders who do not relect on...

Chronic diseases account for an ever growing majority of the US health care spend.  Controlling these costs through better management is not easy, but can be done. Whether that will lower total health care costs is debateable.

The CBO has stated that Medicare Advantage Plans are being payed 12% more than Fee for Service programs. Typically plans that contract for these government funded programs offer additional benefits at the same or even lower costs.  There is also some confusion on behalf of clients, enrollment...

This article identifies the issues associated with race and the hidden biases that impact the care given by providers. To improve this situation one must first identify it as a problem, as has been done here, develop educational programs for providers to assist them in identifying and changing this...

Contingent commissions, if not disclosed, can result in brokerage clients not knowing how much they are paying for the services they receive from their risk brokers. A commission should be viewed as just an alternative to fee-based consulting.  In theory the amount of commissions received should...

The Centers for Medicare and Medicaid Services has proposed a 9.9% cut in payment to physicians for 2008. This is a very real possibility and results from a legislative requirement that the Agency is required to act upon. Congress has stepped in each year for the last five years to counteract reductions...

The Initial concept introduced by Governor Bush was an innovative and functional concept.  Some of the changes introduced at a Special Session placed limitations on the scope of providers and implementation schedules. While there are some early problesm cited int his article they are not that different...

Aon, CHUBB, WILLIS, Marsh and McLennan, Travelers (AOC, TRV, CB, MMC, WSH) Miss Contingency Fees Contingency FeesLosing $1,000,000,000+ of revenue is going to affect earnings and disrupt the status quo of doing business.  The article is a good summary of who has paid the largest fines, and is...

Providing incentives for people to engage or maintain healthy lifestyle choices is a good idea. Those who are already doing the right thing will see an immediate benefit while those who are not will see that there are direct cost consequences associated with their lifestyle. This type of program...

There are ways to control costs, reduce premiums and provide access to quality healthcare plans. Creativity in plan design and customization of plans are key areas insurers are exploring in order to meet the demands of current trends and to build and retain customer loyalty.