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Health Maintenance Organizations

June 1, 1989
Maxicare Will Cut 100 Jobs: Maxicare Health Plans Inc. said it will eliminate about 100 jobs at its corporate headquarters in Los Angeles. The company, which in March filed for protection from creditors under Chapter 11 of the federal bankruptcy code, said it is reducing staff, effective July 28, because it operates substantially fewer health maintenance organizations. Maxicare has sold more than 20 operations since early 1988.
April 1, 2008 | Jordan Rau, Times Staff Writer
Gov. Arnold Schwarzenegger's administration has moved to ban physicians and hospitals from billing patients for the cost of services above what their HMOs are willing to pay. Such bills, which patient advocates call a consumer abuse, are the product of a protracted feud between insurers and healthcare providers, principally emergency room doctors, radiologists and anesthesiologists.
Secure Horizons, the nation's largest Medicare HMO, said Thursday it will freeze membership next year in 41 counties nationwide, most of them in California. The announcement that new members will not be accepted in 24 California counties, among them Riverside, San Bernardino, Santa Barbara, Kern, Alameda and Contra Costa, came as Secure Horizons' parent company reported disappointing results for the third quarter, though they beat estimates. Santa Ana-based PacifiCare Health Systems Inc.
February 5, 2008 | Jordan Rau, Times Staff Writer
In 2002, California's HMO czar, Daniel Zingale, declared, "The days are over when they could make patients wait and wait for healthcare." Zingale was heralding a new law that required his department to ensure that HMO patients received timely appointments with doctors. The law was spawned by the case of a 74-year-old woman who died from an aneurysm in a Kaiser Permanente waiting room while pleading to see her physician.
March 26, 1989 | BRANT S. MITTLER, M.D., BRANT S. MITTLER, a cardiologist in San Antonio, is president of Physicians Who Care, a national grass-roots organization with a broad agenda of public education issues, including the promotion of private practice in medicine. He is also a medical reporter for KENS-TV in San Antonio. and
The financial troubles of Maxicare, at one time the largest for-profit health maintenance organization in the United States, do not mark the beginning of the end of the troubled HMO industry. Rather, Maxicare's troubles merely clear the decks for the emergence of a strengthened movement in government and industry to force medical consumers into HMOs.
PacifiCare Health Systems and Health Plan of America on Tuesday announced a proposed merger that would form one of the three largest health maintenance organization in California, company officials said. The merger would give Cypress-based PacifiCare the foothold in Northern California that its rivals, including FHP International Corp. in Fountain Valley, have sought.
Contrary to many expectations, older heart attack patients enrolled in health maintenance organizations received better medical care than similar patients treated by private doctors, according to a new study from the UCLA Medical Center and the Santa Monica-based RAND Corp. The results, announced Saturday in Seattle at a meeting of the American Federation for Clinical Research, reinforce studies over the past decade.
The short, bearded man in a gray, double-breasted suit walked swiftly through a Long Beach medical clinic, pivoting often to point out cosmetic flaws that might mar the image of the health-care organization he spent a lifetime building. The clinic's young managers obediently took notes as Dr. Robert Gumbiner pointed scornfully to some tattered telephone directories, wheelchairs that obstructed a hallway and two pictures hung askew in a waiting room.
December 24, 1992 | DON LEE, TIMES STAFF WRITER
In what analysts say could be the nation's largest initial public offering of a health insurance firm, Blue Cross of California next month hopes to raise more than $400 million in a stock sale from its new for-profit subsidiary. Blue Cross, based in Woodland Hills, is currently a nonprofit entity. But its new subsidiary, WellPoint Health Networks Inc., will represent virtually all of Blue Cross' operations, having 2.1 million members statewide.
July 26, 2007 | Tracy Weber and Charles Ornstein, Times Staff Writers
Kaiser Permanente will be assessed a record fine today for its haphazard investigations of questionable care, physician performance and patient complaints at its California hospitals, according to state HMO regulators. The California Department of Managed Health Care said it will levy a $3-million fine against Kaiser, the largest HMO in the state, with 29 medical centers and more than 6 million members.
July 17, 2007 | Lisa Girion, Times Staff Writer
State regulators Monday postponed a hearing originally set for this week on complaints against Blue Cross of California, because its parent company has requested a more detailed agenda. The hearing now is set for Aug. 7 in Los Angeles. The state Department of Managed Health Care, which oversees HMOs, said last week that it had received more than 1,600 complaints from policyholders and doctors in less than three years against Blue Cross, the state's largest health insurer.
November 30, 2006 | Daniel Yi, Times Staff Writer
California consumers continue to pay lower premiums with health maintenance organizations than with other forms of health insurance. But the state's HMOs may be losing their ability to contain prices and are no longer much cheaper than their counterparts elsewhere in the country, according to a report released Wednesday.
June 14, 2006 | From the Associated Press
Rate increases for health maintenance organizations are set to decline in 2007 for the fourth consecutive year, but still create challenges for employers, according to a report released Tuesday. Preliminary figures indicate that HMO rates will jump 11.7% next year, down from initial estimates of 12.4% in 2006 and 13.7% in 2005, said Hewitt Associates, a consulting firm based in Lincolnshire, Ill.
April 9, 2005 | Lisa Girion, Times Staff Writer
HMOs, once the top choice for Americans who get healthcare as a job perk, are so last century. Tightly controlled health maintenance organizations have steadily lost ground over the last decade to preferred provider organizations, which offer greater choice of physicians and hospitals and direct access to specialists -- though at a higher price.
January 5, 2005 | Lisa Girion, Times Staff Writer
California regulators proposed prescription drug protections for HMO members Tuesday, describing the rules as the nation's first to mandate broad coverage of medically necessary medications. Although they hailed the thrust of the draft regulations, patient advocates said they feared vague language could allow health maintenance organizations to raise drug co-payments beyond the reach of many consumers, contradicting the spirit of the 2002 law the rules are supposed to implement.
November 21, 2004 | Judy Pasternak, Times Staff Writer
Long before it ended up attached to a budget bill being voted on by Congress, the effort to ease legal requirements to provide abortion services was underway in community hospitals across the country. The omnibus spending bill approved Saturday by the House and Senate contains a provision that will allow hospitals and health maintenance organizations to refrain from providing abortions and related services. President Bush is expected to sign it into law.
November 4, 2004 | From Times Staff and Wire Services
Two Southern California HMOs posted higher third-quarter earnings Wednesday, which PacifiCare Health Systems Inc. and Molina Healthcare Inc. separately credited in part to a flood of new members. Shares of PacifiCare, the biggest manager of U.S. Medicare health plans, rose 19% after third-quarter earnings beat analysts' estimates and the company raised its 2004 forecast. Shares of most healthcare companies rallied Wednesday because of President Bush's reelection.
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