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HMO means Health Maintenance Organization

Thanks Jo, for telling me that! Does that mean that once a person is under a particular HMO, he or she will never be able to see doctors other HMOs?

In Singapore, citizens get government subsidies when they go to government clinics or hospitals for treatment

However, there is

no such subsidy if the doctor is in private practice. Also, the citizen is not eligible for subsidy of he or she is referred to a government hospital from a doc in private practice, such as general practioners.

Ling

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In a message dated 6/21/00 11:23:37 AM Eastern Daylight Time,

tulips3@... writes:

<< HMO means Health Maintenance Organization

Thanks Jo, for telling me that! Does that mean that once a person is under

a particular HMO, he or she will never be able to see doctors other HMOs?

>>

As long as they stay a " member " of that HMO. So as long as they have that

insurance coverage they must continue to see doctors in that plan.

But they can change insurance plans or HMOs if their employer offers others

Jo

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  • 9 months later...
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Which is why we need to build a grass roots base of doctors whom will always

stay involved legislatively with continued contact with their local law

makers, especially while out of session. This type of one on one contact is

vital for us to turn the tide against managed care and closed panels etc.

The CAO your only trade organization also needs your memberships, next year

we anticpated that 50% of membership dues can go towards PAC funds and PR!

Vern Saboe

HMOs

> My wife was watching a TV news piece on Eugene's channel 9 this morning.

> Evidently, AMAs from a number of states are bringing suite against HMOs

> for denial of claims, denial of dx testing, telling the doctor what drugs

> to use, etc. The AMAs also complained about the increased overhead from

> the paper work and audits. The AMA representative said many older docs

> are just retiring while new docs are going bankrupt. Gee, they have it

> rough!

>

> But, think plight of the DC. We have all the MD's HMO challenges and we

> lose patients when their PPO coverage changes and we are excluded from

> their new insurance group. The new DCs plight is more challenging. They

> are even locked out of healthcare insurance groups by older DCs in this

> state who have banded together. Great idea - starve the young of your

> profession! Force the new DCs into PI and Cash practices. No wonder

> over 50% of chiropractic graduates fail in the first year. It is not

> like the old days when Chiropractic education was relatively inexpensive.

> The new graduate faces an average $80,000 plus debt and four years out

> of not making money. Is there any wonder why enrollments are down at

> chiropractic colleges? Word of mouth does travel quickly.

>

> We need to pass either the CAO backed bill in Salem that eliminates the

> closed panels or pass the ballot measure. Maybe we will also benefit

> from the Various states AMA legal action.

>

> DeSiena

>

>

>

>

>

>

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I agree!

DeSiena

On Wed, 28 Mar 2001 09:33:54 -0800 " Vern Saboe " <las@...> writes:

> Which is why we need to build a grass roots base of doctors whom will

> always

> stay involved legislatively with continued contact with their local

> law

> makers, especially while out of session. This type of one on one

> contact is

> vital for us to turn the tide against managed care and closed panels

> etc.

> The CAO your only trade organization also needs your memberships,

> next year

> we anticpated that 50% of membership dues can go towards PAC funds

> and PR!

>

> Vern Saboe

>

> HMOs

>

>

> > My wife was watching a TV news piece on Eugene's channel 9 this

> morning.

> > Evidently, AMAs from a number of states are bringing suite

> against HMOs

> > for denial of claims, denial of dx testing, telling the doctor

> what drugs

> > to use, etc. The AMAs also complained about the increased

> overhead from

> > the paper work and audits. The AMA representative said many older

> docs

> > are just retiring while new docs are going bankrupt. Gee, they

> have it

> > rough!

> >

> > But, think plight of the DC. We have all the MD's HMO challenges

> and we

> > lose patients when their PPO coverage changes and we are excluded

> from

> > their new insurance group. The new DCs plight is more

> challenging. They

> > are even locked out of healthcare insurance groups by older DCs in

> this

> > state who have banded together. Great idea - starve the young of

> your

> > profession! Force the new DCs into PI and Cash practices. No

> wonder

> > over 50% of chiropractic graduates fail in the first year. It is

> not

> > like the old days when Chiropractic education was relatively

> inexpensive.

> > The new graduate faces an average $80,000 plus debt and four

> years out

> > of not making money. Is there any wonder why enrollments are down

> at

> > chiropractic colleges? Word of mouth does travel quickly.

> >

> > We need to pass either the CAO backed bill in Salem that

> eliminates the

> > closed panels or pass the ballot measure. Maybe we will also

> benefit

> > from the Various states AMA legal action.

> >

> > DeSiena

> >

> >

> >

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,

I agree that the HMOs have locked out DCs to a large extent, but you would

be surprised how many MDs I speak with who tell me not to complain too

loudly. HMOs are cutting medical reimbursements all the time, and the end

result is that many MDs are getting forced out of practice (early

retirement) or are simply living on a lot less money than they are used to.

HMO participation is a two edged sword, and greater DC involvement will

ultimately end up dropping income across the board, in my opinion.

Currently, the DC still has the option to have a cash only practice,

something that is really not avaliable to the MD because there is too much

competition that will take the pittance the insurance is willing to pay

after they pre-authorize etc.

D Freeman

Mailing address: 2480 Liberty Street NE Suite 180

Salem, Oregon 97303

phone 503 763-3528

fax 503 763-3530

pager 888 501-7328

HMOs

> My wife was watching a TV news piece on Eugene's channel 9 this morning.

> Evidently, AMAs from a number of states are bringing suite against HMOs

> for denial of claims, denial of dx testing, telling the doctor what drugs

> to use, etc. The AMAs also complained about the increased overhead from

> the paper work and audits. The AMA representative said many older docs

> are just retiring while new docs are going bankrupt. Gee, they have it

> rough!

>

> But, think plight of the DC. We have all the MD's HMO challenges and we

> lose patients when their PPO coverage changes and we are excluded from

> their new insurance group. The new DCs plight is more challenging. They

> are even locked out of healthcare insurance groups by older DCs in this

> state who have banded together. Great idea - starve the young of your

> profession! Force the new DCs into PI and Cash practices. No wonder

> over 50% of chiropractic graduates fail in the first year. It is not

> like the old days when Chiropractic education was relatively inexpensive.

> The new graduate faces an average $80,000 plus debt and four years out

> of not making money. Is there any wonder why enrollments are down at

> chiropractic colleges? Word of mouth does travel quickly.

>

> We need to pass either the CAO backed bill in Salem that eliminates the

> closed panels or pass the ballot measure. Maybe we will also benefit

> from the Various states AMA legal action.

>

> DeSiena

>

>

>

>

>

>

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Colleagues,

I must tell a story shared by a NW medical doctor over breakfast yesterday.

He told the story of how the Portland internists "bit the big one" in the mid 1990's.

This was a tale that somehow I had missed over the last decade. The orthopedist's collapse seemed to be more well known and was more widely covered by the media, perhaps because of the number of mergers and buy-outs. But the internist's story-line I found facinating as it had many similiar characteristics to our own.

The doctor and I had got off on a discussion of managed care by way of my mentioning the upcoming anywilling provider bill. He stated that 35 percent of Portland internists retired early or sold their practices after the implementation of the major plans, which quickly led to the collapse of their economics and practice freedoms.

The pearl of his story however, and the comment that struck me was:

....to this day, when in conversation, they still don't know what happened to them. They continue to blame it on "economic forces"...

He elaborated on this onus by stating that his peers never understood the mechanisms at work involved in their overthrow and loss, in effect, how the doctors gave up their businesses, their economics and their profession to mid-management adminstrators. It was the equivalent of a hostile take-over. He emphasized that they had had a terrible failure of leadership, that they were unable to establish a majority as a collective bargaining group, and that overall it was a trade group that had failed to protect its own interests.

As I listened to his story all I could do is think to myself how similar our stories were.

He also used an interesting analogy of how he and other internists have survived. He described it as a wind tunnel. Within the tunnel there are devastating winds of 200 mph or greater yet there are large rocks to hide behind where the winds bend up and over the top and sides of these heavy landmarks. He says that many of his colleagues who have refused to participate in managed care have found these rocks as points of survival. Behind them they work with the life threatening winds howling by.

Again, I thought of all the things chiropractors have done to survive outside of managed care.

My remaining question is: do we have the same confusion and ignorance here in Oregon about what happened to our profession?

Or are we now beginning to see clearly just what bill-of-goods was sold?

Remember: We Won We Won We Won?

Remember how the kicker was that SB1197 mandated that chiropractic be included in this new thing called "managed care?" Remember we were supposed to be thrilled and impressed that this inclusionary amendment was adopted by the House and Senate?

That was our win?

Whose win?

S.

www.shephardfox.com

ps: keep your eyes peeled for a analytical column by MC pioneer Steve Lumsden in the next CAO Journal!

HMOs> > > > My wife was watching a TV news piece on Eugene's channel 9 this > morning.> > Evidently, AMAs from a number of states are bringing suite > against HMOs> > for denial of claims, denial of dx testing, telling the doctor > what drugs> > to use, etc. The AMAs also complained about the increased > overhead from> > the paper work and audits. The AMA representative said many older > docs> > are just retiring while new docs are going bankrupt. Gee, they > have it> > rough!> >> > But, think plight of the DC. We have all the MD's HMO challenges > and we> > lose patients when their PPO coverage changes and we are excluded > from> > their new insurance group. The new DCs plight is more > challenging. They> > are even locked out of healthcare insurance groups by older DCs in > this> > state who have banded together. Great idea - starve the young of > your> > profession! Force the new DCs into PI and Cash practices. No > wonder> > over 50% of chiropractic graduates fail in the first year. It is > not> > like the old days when Chiropractic education was relatively > inexpensive.> > The new graduate faces an average $80,000 plus debt and four > years out> > of not making money. Is there any wonder why enrollments are down > at> > chiropractic colleges? Word of mouth does travel quickly.> >> > We need to pass either the CAO backed bill in Salem that > eliminates the> > closed panels or pass the ballot measure. Maybe we will also > benefit> > from the Various states AMA legal action.> >> > DeSiena> >> >> >

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Listmates;

Very well said Doctors...

As previously mentioned, if the first Doctor NEVER signed on with ANY managed care program that reduced his fees, there would be but little trouble in the health care business!!!!!!

ALL health care providers should not renew their contracts with any PPO, HMO ,ECT that reduces fee, and there will be a drastic and rapid change in the professions!!!

See ya all at convention

DrBob

HMOs> > > > My wife was watching a TV news piece on Eugene's channel 9 this > morning.> > Evidently, AMAs from a number of states are bringing suite > against HMOs> > for denial of claims, denial of dx testing, telling the doctor > what drugs> > to use, etc. The AMAs also complained about the increased > overhead from> > the paper work and audits. The AMA representative said many older > docs> > are just retiring while new docs are going bankrupt. Gee, they > have it> > rough!> >> > But, think plight of the DC. We have all the MD's HMO challenges > and we> > lose patients when their PPO coverage changes and we are excluded > from> > their new insurance group. The new DCs plight is more > challenging. They> > are even locked out of healthcare insurance groups by older DCs in > this> > state who have banded together. Great idea - starve the young of > your> > profession! Force the new DCs into PI and Cash practices. No > wonder> > over 50% of chiropractic graduates fail in the first year. It is > not> > like the old days when Chiropractic education was relatively > inexpensive.> > The new graduate faces an average $80,000 plus debt and four > years out> > of not making money. Is there any wonder why enrollments are down > at> > chiropractic colleges? Word of mouth does travel quickly.> >> > We need to pass either the CAO backed bill in Salem that > eliminates the> > closed panels or pass the ballot measure. Maybe we will also > benefit> > from the Various states AMA legal action.> >> > DeSiena> >> >> >

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  • 8 years later...

Could someone tell this Brit what an HMO is.

Lida in London

-----Original Message-----From: [mailto: ] On Behalf Of Sent: 08 October 2009 06:38 Subject: Re: It Must be TIme

CI read 's letter and rather than answering him separately (since it is late and I am about to nod off), I want to add that many of us US-based people, if not most of us, are in HMOs these days! Some of us in this group particularly may tend to have supplemental Medicare as well In my case the Medicare is my secondary payer, so the HMO gets billed first and I have to follow its rules for referrals. I did need to switch to a PPO temporarily to get my initial revisions done in Boston, but I am fortunate to have found topnotch surgical care and pain management closer to home now, and all my current docs are on the HMO's approved list. I've been through five more spinal revision procedures and a number of pain-pump-related surgeries with the HMO.Best,

..

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