Managed Care Report
Managed Care Report
• Senior Care Action Network (SCAN; Long Beach, CA) has named George Garnett medical director. Prior to joining SCAN, Garnett was medical director of ProMed Health Care Administrators, a physician management organization.
• Humana (Louisville, KY) has appointed Arthur Lazarus vice president and corporate medical director of behavioral health. In the newly created role, he will develop and devise strategies to better integrate primary care and behavioral healthcare services to enhance early treatment of behavioral disorders among Humana health plan members. Lazarus will also be responsible for expanding disease management programs and preventative services related to mental health.
• Blue Cross and Blue Shield of Florida (BCBSFL; Jacksonville, FL) last week reported consolidated revenues in 1Q99 grew nearly 20% to $1 billion from $874.2 million in 1Q98. Chris Doerr, senior vice president/CFO, said," Strong enrollment gains, including our acquisition of Principal Healthcare of Florida, reflected favorably on our revenues and helped strengthen our market leadership in Florida." Overall, the company enrolled more than 250,000 new members in 1Q99, he said. About 60% of this member increase, Doerr said, was due to the company’s acquisition of Principal Health Care of Florida. During 1Q99, the company also reported, policyholders’ equity increased by $26.1 million, from $818.2 million during 1Q98 to $844.3 million during 1Q99. Policyholders’ equity enables BCBSFL to meet its obligations when claims or expenses are higher that expected or during times of economic uncertainty.
• HIP Health Plans (HIP; New York), to keep pace with the competitive healthcare environment, said last week that it continues to make a number of strategic operating changes in New York and Florida. HIP Health Plan of Florida, HIP said, will not renew its Medicare+Choice contract for the Tampa area, which includes Hillsborough, Pasco, Pinellas, and Hernando counties, effective Jan. 1, 2000. HIP says about 2,000 current members will be affected, but will have until Jan. 1 to find a new healthcare plan. The reason for withdrawing, HIP said, relates to medical costs in the Tampa, FL, area significantly exceeding the reimbursement increases authorized by Medicare.
• Blue Cross and Blue Shield of South Carolina’s (BCBSSC; Columbia, SC) Adie Fuentes will be awarded the 1999 Beneficiary Services Certificate of Merit at the annual Health Care Financing Administration (Baltimore) conference in Miami. Fuentes is a senior ombudsman at Palmetto Government Benefits Administrators, which is the official name for all government programs administered by BCBSSC, working in Puerto Rico and the Virgin Islands.
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