There's plenty of ill will between hundreds of Denver-area physicians and PacifiCare of Colorado, in the aftermath of the collapse of a management company that represented four practices. The PPM, Millenial, was a middleman between health plans and the physician groups that are composed of 190 primary care doctors and 1,000 specialists and that serve 80,000 PacifiCare members.

PacifiCare fired the first shot, telling the physicians in mid-November it would no longer make capitation payments to Millenial and would, instead, pay the doctors directly. PacifiCare said it was concerned about Millenial's financial stability, and had received complaints from its physicians about not being paid on time.

The physicians were told to sign new contracts with the HMO by Dec. 8, or risk being kicked off its provider panel. Millenial called it an act of desperation, in that PacifiCare had yet to sign agreements with several other large physician groups; had lost Med South, a large group unaffiliated with Millenial; and was concerned about having an inadequate physician network.

Without its PacifiCare revenue, Millenial quickly succumbed, ceasing operations on Dec. 15. Soon after, at least one Millenial group, South Metro Physicians, didn't blink; the group chose to leave the HMO. Negotiations with at least two other groups were continuing at presimprme.