[MOL] HMO"S, INS. SERIES, Part 7..... [00731] Medicine On Line

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[MOL] HMO"S, INS. SERIES, Part 7.....

  NOVEMBER 11, 1999

HMOs Not Likely to Change Policies

      Earlier this week, the nation's second-largest health insurer announced doctors, not insurers, would have the final say on treatment, but experts don't expect other health plans to follow suit.
       While the move by United Health drew praise from President Clinton, other managed-care health plans don't appear to be inching toward adopting similar policies. Clinton also supports federal legislation that would give patients the right to sue their health maintenance organizations if a treatment isn't covered. But industry experts say other managed-care companies depend on scrutinizing the day-to-day decisions of doctors to keep costs down.
      United Health says its decision made financial sense since the company was spending too much money to scrutinize doctors' decisions, of which 99 percent were approved by United anyway. Many health-care experts hailed the move as historic and as a victory for patients and doctors. However, Aetna, the nation's largest health insurance company, says it has not reviewed United Health's strategy and would not comment on it.


Warmly, lillian
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