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Managed Care and Physician Contracting

Most physicians have contracts with physician managed care plans. The Center for Studying Health System Change (2002) reported that 91 percent of physicians had one or more managed care contracts in 2001. On average, responding physicians had contracts with 13 managed care plans and received nearly 46 percent of their practice revenue from these plans. These reports are broadly consistent with earlier surveys conducted by the American Medical Association (AMA 1998), (more…)

Family Medical Insurance – Tips of Choosing the Right One

It is more than common to have family medical insurance policies, looking for a lot of questions arise, how to find the right one base on your needs. This article aims to answer some basic questions about hot to choose affordable family medical insurance policies. (more…)

Medicare Adjusted Average Per Capita Costs (AAPCC)

Since Health Maintenance Organizations (HMOs) do not have a claims database, they were at a disadvantage in participating in rating Medicare when it was introduced in 1965. After a number of largely unsuccessful efforts, Medicare implemented in 1985 the Adjusted Average Per Capita Costs (AAPCC) payment methodology under authorization from Congress in the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA). There is a history of Medicare’s approaches to paying managed care plans in its first 35 years. (more…)