Philadelphia's Jefferson Health System has threatened to drop Independence Blue Cross June 1 unless a new contract can be hammered out. Few expect that to happen — Jefferson makes up 20 percent of IBC's business, while the insurer means a quarter of Jefferson's revenue. But both sides sent letters to patients and members to frame the issues — a sign of how health systems are increasingly taking their disputes straight to the public.... Whether you're in an HMO or an indemnity plan, there's no difference in your likelihood of being hospitalized or having access problems, according to a Center for Studying Health System Change study. While that skewers the perception of HMOs as barriers to care, it raises questions about their ability to control costs.... The prospect of lower out-of-pocket costs is far more important to people who join Medicare HMOs than prescription-drug benefits, according to a study by the Office of the Inspector General... The Academy for International Health Studies has launched a feasibility study into a cross-border health plan that would cover people who work and live in the U.S. and their families living in Mexico.