The IRE Resource Center is a major research library containing more than 23,250 investigative stories — both print and broadcast. These stories are searchable online or by contacting the Resource Center directly (573-882-3364 or rescntr@ire.org) where a researcher can help you pinpoint what you need. Browse or search the tipsheet section of our library below. Stories are not available for download but can be easily ordered by contacting the Resource Center:
Search results for "Health Maintenance Organization" ...
-
Day of the Dead: The declining autopsy rate is hurting medical science
This article discusses the declining rate of autopsies being performed nationwide, and their implications for medical science. "Doctors are reluctant to request them, scared to discover a misdiagnosis that could lead to an expensive malpractice suit. Health maintenance organizations and government agencies are reluctant to pay for them. And there is a shortage of doctors trained to perform them." The article examines the various benefits autopsies offer the medical community -- from measuring the effects of new drugs to understanding various diseases and other health problems, and the possible benefits to families who want to determine just how their loved one died, and from what. The growth of one Los Angeles-based discount autopsy business, 1-800-AUTOPSY, is also discussed.
Tags: autopsy; medical examiner; coroner; HMO; health insurance; science; medical science; death; deceased; organs; research; pathologist; discount business
-
Twisted System: A Phoenix family stumbles through the tangled bureaucracy of modern medical care.
This article talks about a family's struggle with an HMO to get coverage to correct their daughter's bent spine, caused by scoliosis. The article details the family's battle, and explains their problems with health care coverage. The health care insurer the family's with is called PacificCare.
Tags: Health Care; HMO; Health Maintenance Organization; PacificCare; coverage; medical insurance; medicine; doctors; money; hospitals; scoliosis
-
HMO's refusing emergency claims, hospitals assert. 2 missions in conflict. 'Managed Care' groups insist they must limit costs--doctors are frustrated.
According to the article, "As enrollment in health maintenance organizations soars, hospitals across the country report that H.M.O.'s are increasingly denying claims for care provided in hospital emergency rooms. Such denials create obstacles to emergency care for H.M.O. patients and can leave them responsible for thousands of dollars in medical bills."
Tags: HMO; H.M.O.; hospitals; emergency rooms; medical bills; doctors; health care; money; health maintenance organizations; emergency care
-
The Death of Family Health Plan: Was it a victim of competition? Or did management changes, regulatory loopholes and bad information contribute to its demise?
Gunn charts the demise of Family Health Plan, a Wisconsin HMO. This demise "was a remarkable meltdown of a once well-established, even venerable player in the local health-insurance marketplace...The insurer was a casualty of the massive changes that have swept through the health-care and health-insurance industries, and of the wholesale turnover of the insurer's top management during the course of those changes."
Tags: family health plan; managed care; managed health care; health maintenance organization; HMO; Wisconsin Office of the Commissioner of Insurance
-
Swiss Miss: When his wife required an emergency transplant, this professor was willing to donate his own kidney -- but CU wasn't willing to pay the price.
Westword recounts the wrangling between the University of Colorado and CU professor Victor Saouma over the cost of an emergency kidney transplant in Switzerland for Saouma's wife, Rhea. The Saoumas were enrolled in CU's employee health plan, which provided health care through the university's Health Sciences Center. The Saoumas had also purchased the Silver Plan, additional coverage that allowed them to get some treatment outside of CU. But with enrollment in this plan dropping and its costs increasing, CU officials dropped the plan altogether. The new plan, called the Gold Plan, did not allow for transplants outside of the Health Sciences Center except in the most urgent of cases. CU tried to avoid paying for the cost of Rhea's kidney transplant while the couple was living in Switzerland for Victor's sabbatical. After being served a lawsuit in the fall of 2000, CU administrators eventually agreed to pay the costs of the surgery, plus interest, legal fees and an additional, undisclosed amount. A 1999 audit of CU's employee health program validated allegations that the plan was mismanaged.
Tags: University of Colorado; organ transplant; health maintenance organization; HMO; university health plan
-
Limited Solace: Managed-Care Firms Handling Mental Health Trigger Complaints
Drawing on the stories of mental health patients and psychiatrists, The Wall Street Journal reports that the managed behavioral care industry "has transformed the treatment of mental illness and substance abuse." These firms, contracted with health maintenance organizations to provide mental health care to their members, "sprang up in response to soaring costs for mental-health benefits." The largest such firm is Magellan Health Services Inc. "As Magellan has grown, so have complaints." Many HMOs and psychiatrists have pulled out of Magellan's "phantom network," while plaintiffs seeking class-action status are accusing the company of fraud.
-
"No Cuts, No Glory"
Dick Rothman, an othopedic surgeon who has run the biggest practice of its kind in the United States, is taking his practice public. But the nation's oldest hospital -- Pennsylvania Hospital -- can't imagine letting him go. He's their most productive surgeon, bringing in millions of dollars annually for the institution. Rothman is the quintessential specialist physician who practiced in an era doctors, particularly specialists, were the center of the health care universe. Now, the federal government, insurance companies and health-maintenance organization tell doctors what to charge. This article explores the reasons why Rothman will have no part of it.
Tags: Health maintenance organizations; specialist physicians; doctors; Pennsylvania Hospital; Dick Rothman; hospitals
-
Bell Saving their assets
In an accelerating rush to the marketplace, many of America's largest health care nonprofits are being converted into profit-making organizations. American Prospect reports on this continuing wave. If it continues, billions of dollars in charitable assets are at risk
Tags: Blue Cross; Blue Shield; HMO; Health Maintenance Organizations; Nonprofits; Philanthropy; Wellness Foundation; HealthNet
-
The Health Care Revoultion
As it has evolved in California, the HMO system often places the medical interests of patients in conflict with the financial interests of their doctors. This Los Angeles Times series documents how health maintenance organizations save money not simply by squeezing waste and inefficiencies from the system, but often by denying necessary medical care to the patients who need it most-the chronically and seriously ill. (August 27 - 31,1995)
-
The Health Care Revoultion: Remaking medicine in California
An in-depth look at the dramatic ways in which California's increasingly powerful health maintenance organizations are influencing medicine in the state. The series finds that HMOs save money not only by eliminating inefficiency, but often by denying necessary medical care to the patient who need it most. (Aug. 27 - 31, 1995)