MANAGED CARE March 1998. ©1998 Stezzi Communications
The Medical Association of Georgia has sued Blue Cross Blue Shield of Georgia, saying the insurer illegally changed its contracts with physicians when it revised its reimbursement formula. Georgia Blues says it changed its payment basis from usual and customary fees to usual and customary fees physicians receive, factoring in Medicare and Medicaid, to close the gap between its indemnity and managed care reimbursements.... As 2000 draws near, plans are trying feverishly to prevent meltdown of their information systems. Kaiser Permanente signed a $23 million contract with Data Dimensions of Bellevue, Wash., to identify and correct problems. Allina Health System and Aetna U.S. Healthcare have enrolled with the Minneapolis-based Rx 2000 Solutions Institute, which provides technical assistance to health care organizations and enables them to help their suppliers and providers get in step.... Group Health Cooperative of Puget Sound offers 100 percent coverage for smoking cessation services. Its policy of having no copayment is the HMO's latest tactic in an aggressive campaign that has helped cut the prevalence of smoking among its members from 25 percent in 1985 to less than 15 percent today.... A new tool for measuring health plan quality: The Agency for Health Care Policy and Research has developed a survey HMOs and employers can give to beneficiaries to criticize plans.The idea is to give members a way to make apples-to-apples plan comparisons.