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MANAGED CARE July 2002. ©MediMedia USA
Vol. 11, No. 7
July 2002
Cover Story
Don't Count Capitation Out Just Yet
There's a national slide away from paying per member per month, but many things in health care are cyclical. The eventual shape of the delivery system will influence whether capitation regains some of its lost prominence.
They shore up bottom lines in the short run, but the long-term effects can be devastating. Can any health plan afford to lose market share or to attract more negative publicity?
The pharmacy director at Blue Cross of Oklahoma describes how his plan successfully implemented a 3-tier formulary with coinsurance, controlling costs with little member anxiety.
Obesity Coverage: Public Must Lead
Before it becomes an accepted benefit, the American people must reach a point of understanding about this condition similar to what was reached about smoking decades ago.
DEPARTMENTS
Rush Prudential HMO v. Moran.
News and Commentary
Survey: Health System Changes Should Not Be Made Too Quickly
CBO Weighs Effect of Growing Deficit on Fed Programs
Memo Clarifies CMS Guidelines on Injectables
Despite Deficits, States Avoid Cutting Medicaid, CHIP Rolls
Headlines on Deadline...
Phantom providers spur real concerns.
Money isn't everything.
Good work flow pays off.
How to solve provider/HMO disputes.
Pharmacy precertification on rise?