News in brief - Sept. 25, 2000

Aetna to get nicer in Georgia - More California IPA casualties - More doctors cancel contracts - Top N.J. officials endorse HMO liability - PPO merger in the plains - Doctors near to buying Ohio hospital - Wisconsin HMOs rebounding

Sept. 25, 2000.

Aetna U.S. Healthcare was expected to announce policy reforms in Georgia similar to what it has announced in Virginia, Florida and Connecticut, according to Georgia Insurance Commissioner John Oxendine.

Aetna declined to comment on reports that its Georgia reforms will include more flexibility for doctors to choose health plans, 90 days' notice for physicians on major payment changes, a fee-for-service option and simplification of its precertification process.

More California IPA casualties

The pace of failures of California independent practice associations, fueled by low reimbursements, is speeding up to about one every two or three weeks, the California Medical Assn. reports.

The latest to close are 500-physician Loma Linda Community Medical Group and 600-physician San Mateo IPA -- the nation's first IPA, founded in 1979.

More doctors cancel contracts

Physicians' cancellations of managed care contracts continue.

In Pennsylvania, Lehigh Valley Physician Group said it would leave Aetna U.S. Healthcare because the cancellation of a contract by a local hospital organization meant that its doctors could not treat Aetna patients there.

In North Carolina, Piedmont HealthCare said it would cancel its managed care contracts with Blue Cross Blue Shield of North Carolina, after negotiations fell apart last week over payments.

Top N.J. officials endorse HMO liability

New Jersey Gov. Christine Todd Whitman and Senate President Donald T. DiFrancesco, both of whom are Republicans, have independently endorsed legislation that would make HMOs liable for coverage decisions.

The proposal is already contained in a bill that had been moving slowly through the Legislature.

PPO merger in the plains

Two large Iowa preferred provider organizations, Midlands Choice PPO and Midwest Select PPO, have merged so that they can better sell services to large employers and independent insurance plans, the new PPO said.

In the states of Nebraska and Iowa, the merger of Midlands Choice and Midwest Select is creating the largest provider-owned PPO network of independently practicing health care professionals located in the Midwest, according to the company.

Doctors near to buying Ohio hospital

A bankruptcy judge has cleared the final hurdle for physicians to buy Deaconess Hospital in Cleveland from its bankrupt owner.

Nour Management, made up of doctors who admit to Deaconess, signed a purchase agreement in July.

Wisconsin HMOs rebounding

Wisconsin's 23 HMOs have earned $1 million so far this year, rebounding from the industry's $58.5 million aggregate loss last year, according to the Wisconsin Insurance Dept.

Almost half of the state's HMOs reported a profit for the second quarter of the year, up from eight in the first quarter.