Description
Book SynopsisThis fifth issue in the Industry and Health Care series takes a quick turn through unpredictable and only partially charted waters.
Table of Contents1. What Can Industry Do for HMOs and HMOs for Industry?.- HMOs and Health Care Costs.- Industry and HMOs.- Notes.- 2. Defining Corporate Strategies and Goals.- Organizational Patterns and Beginning Steps.- Savings Potential in an HMO: The First Cut and a Second Look.- Data Deficiencies: Approximations and Proxies.- The Current Benefit Package and Management—Labor Relations.- The Physician—Patient Relationship and the Tightrope of Medical Politics.- Geography: Concentration and Clout.- The “Bottom Line” Is the Bottom Line….- …Or Is It?.- Notes.- 3. Identifying Available Options.- Salaried Group HMOs: Roots in Prepaid Group Practices.- Fee-for-Service HMOs.- Other Emerging HMO Models.- Potential Partners for HMO Development.- Notes.- 4. Assessing Legal Obstacles.- Liability Issues for the HMO.- Corporate Liability.- State Law.- ERISA.- Antitrust Law.- Conclusion.- Notes.- 5. Issues for the Future.- The Issues for Industry: Setting Realistic Expectations and Goals.- The Issues for HMOs: Amassing Useful Data and Establishing Credible Records.- The Broader Policy Issue: Who Ought to Realize the Savings?.- Notes.- Appendix I A National Call to Action: Secretary Califano’s HMO Conference.- Appendix II Bay State Health Care Foundation Hearings.- Appendix III Panel Discussion: Should Industry Sponsor Fee-for-Service HMOs?.
