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Home > Resources > eNews > Dec 1999 |
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The Managed Care Insider eNews Volume One Number 5 December 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 focuses on the past as an influence on the future of health care. In Part One we focus on philosophical views related to changes being implemented by various health care organizations in an attempt to try to build a more positive image as they react to negative public opinion polls in which consumers note their continued dissatisfaction with the delivery of health care. In Part Two, we present an esoteric discussion of a real life situation which personifies the very essence of this consumer dissatisfaction. As always, we welcome and encourage your comments and suggestions. Email us at insider@scheur.com. Also, we would like to encourage you to please visit our archives page on our web site at http://www.scheur.com/smghome.nsf/webcontent/ezinearchives.html where you can rate our eNews! Please take a moment to do so. Thank you! Insider Vision: The New "Fairness" to Doctors: Spin Doctoring or Reality? by Barry S. Scheur, President Scheur Management Group United Healthcare's recent announcement that doctors will finally be allowed to make unencumbered medical decisions is a brilliant piece of public relations. The trouble is: Isn't this the way it always should have been and what does this say about the abuse physicians have felt from HMOs for over a decade? The real question is not whether doctors can finally be allowed, like school children getting older, to authorize tests and make referrals, but whether or not the underlying behavior that has fueled the managed care backlash will really be changing. This whole issue is not about changing policies and procedures; on the contrary, it's about aligning incentives for physicians as the care partners in managed health care quality and financial risk. Belatedly giving physicians the freedom to practice medicine, without fundamentally re-thinking how physicians should be compensated and share in re-shaping managed care, is like building a great new car, but with a lousy engine. Physicians and hospitals need to be treated like the valued customers and partners that they are as together we figure out how to fix a broken health insurance industry, fueled by consumer complaints and the specter of class action lawsuits (a topic for later discussion). Physician education, timely payment of claims, and common sense courtesy, along with fair contracting, are the only solutions for what really ails the managed care industry. The partnering with providers is one of the main reasons Venture Health Partnership Group (VHPG, see October 27th edition eNews) was created. VHPG, in its acquisition of local HMOs, is committed to more than the window dressing of physician autonomy. Service, reimbursement, and valuing relationships are commitments with which this industry must come to terms. At VHPG, we intend to set the standard in managed care, not as rhetoric, and not just because it will make money, but also, because we are passionate in our belief that doing right for patients and physicians is long overdue. So United and Aetna have now spoken. I look at their decision as something dictated to them, not some conclusion that they came to out of belief in what really will fix the health care system. A change of policy is not a change in behavior. On that note, we'll wait to see the real results! ---------------------------------------------------------------- For questions, information regarding VHPG, please contact Public Relations through nbelle@scheur.com ---------------------------------------------------------------- What's New at SMG? It's here! We invite you to take the MCO Challenge! MCO Challenge is a brief, beta test survey for managed care organizations as a means of assessing the "health" of its plan. Take the fitness test now! It's free and it's fast. Find out where YOUR organization stands in its operational, marketing, and financial work processes. Note: This survey is based solely upon the provided answers to questions and as such, is not intended to be representative of, nor a replacement for, a comprehensive on-site evaluation of your MCO. However, survey responses can be an indication that a more in-depth analysis of that function, or of the scope and practice of the MCO, may be needed. The MCO Challenge is brought to you by MCORE, Managed Care Operational and Revenue Enhancement Program, created and performed by the SMG industry experts and led by chief medical officer Dr. Paul Reich. For more information visit http://www.scheur.com/smghome.nsf/webcontent/servicesproductmcore.html. ---------------------------------------------------------------- What's In Store at SMG?? You've heard and read all the hype about "e-Commerce!" Get ready for practical, realistic, website solutions for taking MCOs through the electronic age of provider/client relationships and branding/marketing services by industry specialists who have been there, and who have done it! SMG is taking managed care to the next level . . . e=mc2 ! Ask me, or Ask SMG . . . Stop at our site, watch for our new launch of services to meet our clients "e-needs." For more information, contact e=mc2@scheur.com. ---------------------------------------------------------------- Sites and Sounds on the Internet: In keeping with this issue's focus on industry changes, 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. HealthLeaders, http://www.healthleaders.com: Is a free subscription service which delivers to your email a listing of all health care happenings. Reuters Health, http://www.reutershealth.com: Is a fee-based subscription service to health news and is syndicated nationally via Reuters. USA Today, http://www.usatoday.com/life/health/health.htm: Is a combination of consumer/professional news stories related to the practice of medicine today.You can also find an audio feed of today's health news. Top Health Stories can be found through almost all search engine portals as in Excite, http://webcrawler-news.excite.com/more/health. Health Industry News and Resources for medical management professionals at http://www.healthindustrynews.com. ---------------------------------------------------------------- End of PART ONE of TWO, The Managed Care Insider eNews, Volume One, Number 5. Scheur Management Group (SMG) is one of the most experienced specialized health care 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 Rob Eichler. 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 December 1999 Part 2 |
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