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Home > Resources > eNews > Oct 1999 |
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The Managed Care Insider eNews Volume One Number 4 October 1999 PART ONE of TWO Welcome to The Managed Care Insider eNews. You are receiving this because you have subscribed; the eNews is never sent unsolicited. Subscribe/unsubscribe information can be found at the end of this eNews. The Managed Care Insider eNews is published, copyrighted, and owned by the Scheur Management Group, Inc. (SMG), http://www.scheur.com and is distributed monthly, free to subscribers. If you wish to forward this edition, you may do so only if the edition is forwarded in its entirety. No reproduction of any part of this publication is permitted without the express permission of the publishers. ---------------------------------------------------------------- This edition of The Managed Care Insider eNews is another two-part publication. We present, in Part One, an optimistic and futuristic view of managed care in the new millennium. And while many of our readers may be tired of articles about the "millennium," the view from healthcare is both exciting and challenging, with changes occurring like tornadoes, leaving providers, payers and professionals scrambling. In Part Two, we present the first in a series of articles which takes both a nostalgic view of the changes affecting hospitals, as well as a futuristic view of what is to come. The series author is David Buchmueller, our newest addition to the SMG team. As always, if you have any comments or suggestions, we want to hear from you. Send your comments to insider@scheur.com. -------------------------------- Insider Vision: A Contrarian View: THERE'S AN OPTIMISTIC FUTURE FOR HEALTH CARE By Barry Scheur In this issue, we explore the past, present and future of many aspects of health care delivery, from payor to provider. This edition also marks the first contribution of David Buchmueller, the most recent addition to SMG, who brings over thirty years of experience in the hospital and health system industry. As we close this century and welcome the challenges that lie ahead, we see evidence of the forces that are impacting, some would say negatively, on the managed care industry. Unlike many of my colleagues, I view these as opportunities that have the potential to reshape positively the way managed way is practiced. Today, everybody's juiced about the Internet as on-line technology for managing health care information; the investor/venture capital community is translating its enthusiasm into significant investment. However, when one talks about the potential for investment or growth in companies that are involved with the delivery or financing of health care, these same financiers just shrug their shoulders. I just don't buy it! Despite all the backlash against managed care (which is really backlash against choices that consumers themselves make regarding pricing, benefits, and access), I think that the health insurance system of the United States is still worth the investment. It is true that people are unhappy with managed care. But, in my opinion, what they are unhappy with is the deception, brought about by lack of information, and surprises when they learn the rules, i.e., read the fine print, when they try to get their claims paid or treatment for illness or injury. But it doesn't have to be that way! Many hospital systems are rethinking their integrated delivery system strategies. They are bailing out of operating their own HMOs, either by closing them down or selling them for a mere fraction of their investment, not to mention their energy and other resources. Physicians have also failed abysmally in implementing businesses to govern, finance and deliver care, primarily because of under-capitalization and grossly poor judgment when it comes to management. When all of the dust dies down, the financing and delivery of care may well be left to several giant public companies such as CIGNA, Aetna, and United HealthCare that have turned health care delivery (as well as insurance) into a business at the expense of physicians and hospitals. Even with all this noise about the failings of our insurance system and the call for class action suits by tobacco litigation lawyers looking for their next windfall, I am optimistic about managed care's potential and I am putting my money where my mouth is. As the president of the new Venture Health Partnership Group (VHPG), I am intent on acquiring and turning around HMOs (primarily those that have been developed independently by hospitals and physicians). My formula for success is based on my passion for full consumer disclosure, a no-compromise attitude toward the best customer service we can provide, and a commitment to reimburse physicians fairly in exchange for their active participation and support. VHPG will give fair contracts and meaningful management information to providers. We want patients to know before they join what benefits they will get and how they will access care -- no run-arounds, no bureaucracy, and no hassles! The insurance products should reflect the needs, benefits and desires of local consumers, not just whatever the HMO's centralized computer system can support this year. Does this sound a little naive? Maybe, but SMG's successful strategy, our reputation for over a decade, has been in building and managing local HMOs and other managed care organizations. And it's still possible now. In January 2000, VHPG will close our first acquisition. We'll then let the marketplace decide whether health care and managed care insurance can be user friendly, provider friendly, and profitable. If we're right, and we believe that we are, we will make a positive difference in the way the world of managed care is viewed and practiced -- an exciting prospect with which to usher in the new millennium! If you would like more information about VHPG, please contact Public Relations at nbelle@scheur.com ---------------------------------------------------------------- Sites and Sounds on the Internet: In keeping with this issue's focus on new strategies, new start-ups, new business ventures and taking risks, we present the following websites for your review. SMG takes no ownership of the following sites, nor does SMG endorse these sites which are presented solely as a resource for subscribers. Resources for CEOs, any CEO, any industry from CEO Express: http://www.ceoexpress.com Canadian Industry Trends and Statistics: http://strategis.ic.gc.ca/sc_ecnmy/sio/homepage.html Industry Specific Trends and Statistics authored by Dept. of Commerce: http://www.stat-usa.gov/ Comprehensive Site for Resources on Emerging Markets Globally with Investor Links and Resources: http://www.investingsites.com/emerging_markets.htm Healthcare Trends-Publications: http://www.healthtrends.net/publications/htr/ Entrepreneur Magazine Presents Business Start-Ups Online: http://www.entrepreneurmag.com/bizstarts.hts How the World Changes Business, and Business Changes the World The New Breed of Fast Companies, from Fast Company Magazine Online, an Interactive Site: http://www.fastcompany.com Practice Guardian News - Practice Guardian.Com Healthcare practice management resources and free monthly newsletter: http://www.practiceguardian.com ---------------------------------------------------------------- What's New at SMG? Watch our site for the launch of the MCO CHALLENGE A quick survey to determine the health/fitness of your MCO at http://www.scheur.com MCOREœ: Managed Care Operations and Revenue Enhancement Review: Intensive three day review of the operations/finance functions and work processes of your MCO by leading healthcare experts. For MCOs who want a non-biased review of their operations; for investors looking to appraise MCOs operational and financial capabilities; for businesses and associations wanting to assess an MCO before contracting. For more information, contact Dr. Paul Reich, Chief Medical Officer, at 617-969-7500 ---------------------------------------------------------------- End of PART ONE of TWO, The Managed Care Insider eNews, Volume One, Number 4. Scheur Management Group (SMG) is one of the most experienced specialized healthcare operations management and business revitalization consulting firms in the country. Our expertise is in time-sensitive analyses, strategic business and market planning, operational re-engineering, and communications, as well as implementation of start-ups, expansions, and new products. The firm's clients cover the spectrum of insurers, managed care organizations, physician groups, integrated delivery systems, hospitals, employers, governmental entities, vendors, and other providers. Contributors to this edition are Barry Scheur and David Buchmueller. Editing and Research by Judith Jaffe. Production Coordinator is The Gracefield Group at http://www.gracefield.com/gg/index.html TO SUBSCRIBE: visit http://www.scheur.com/smghome.nsf/webcontent/ezine.html or send e-mail to insider@scheur.com with the word SUBSCRIBE in the subject and name, email, company, title, and country in the message. TO UNSUBSCRIBE: send email message to insider@scheur.com with the word UNSUBSCRIBE in the subject. Please take a minute to visit our eNews page at http://www.scheur.com/smghome.nsf/webcontent/ezine.html for archives, subscriber information and to RATE our ezine. Get up-to-the-minute health care news on-line at www.scheur.com Go to October 1999 Part 2 |
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