Will it work? Despite initial applause, the future of L.A. County's two-plan model for serving Medicaid beneficiaries remains uncertain.
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Publications and source records attributed to L Kertesz.
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While some provider-owned managed-care plans have sold to investor-owned companies, most aren't as bottom-line oriented, according to Modern Healthcare's HMO/PPO Survey. Even plans that lost money last year are investing in information systems, new products, geographic expansion and mergers with other provider-owned plans. Several survey respondents are market leaders that have won national recognition.
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The HMO industry is on a mission to repair its battered image. Led by the America Association of Health Plans, the campaign includes patient-centered policy statements and an emphasis on involving doctors in quality programs. Some observers detect signs of improvement, but many industry insiders are wondering if the effort is too little, too late.
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Managed-care companies have caught a big merger wave, winning applause from Wall Street and some analysts who say the deals offer great financial potential. But others, including consumer groups and some providers, say the health plans could be surfing toward a spill. Critics question the tactics the companies are using and contend the firms are serving the short-term demands of the financial community but aren't helping their long-term business.
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