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The aftermath of the Carilion merger.

What's up since the controversial Carilion merger in Roanoke, Va., was consummated in July 1990? Prices, costs and construction for starters. A competitor is up, too, up in arms that is. During its long battle with the Justice Dept. over antitrust questions, Carilion argued that the proposed merger could provide significant economic efficiencies. But the system's main competitor contends that just hasn't been the case.

Antitrust Laws↗

Reviving America's failing health care system.

America is now at an important crossroad regarding its health care system, writes H. Wilson Graves, M.A., M.P.A., explaining that Americans increasingly see this system as a "paradox of excess and deprivation." Graves believes increased competition is the only viable alternative to revive our ailing health care system.

Community Participation↗

The center of caring: adult day care & the VNA.

Day care services in conjunction with home care aide services provide a cost-effective, humane solution to caregiver burnout and/or the possible financial and emotional devastation of institutionalization. One adult day care center makes the most of community resources, including the local VNA.

Adult↗

Achieving incremental volume increases.

Despite provider assumptions that managed care contracts will yield incremental increases in patient volume, there are no guarantees that volume increases will be realized. Providers can improve the likelihood that incremental volume increases will be achieved, however, by including certain provisions in managed care contracts related to volume-based discounts, limitations on network size and composition, access to physicians, provider directory listings, patient financial incentives, service scope/carve-outs, and participation in all service products offered by the managed care organization. Negotiating such provisions may be difficult, but providers and managed care organizations that reach agreement on these provisions gain mutual understanding and frequently can form more successful relationships.

Community Networks↗

Brave new world.

The new budget bill means big changes in Medicare. The elderly are expected to help save the program by switching to less costly health care options. But some experts warn seniors that more choice means more risk.

Aged↗