Managed Health Care's New Player Medical Pros Step in Market

Article excerpt

ATLANTA -- Medical professionals in Georgia are winning approval

for new businesses that might help them win some of the booming

managed health care market -- hospital HMO-like corporations.

Georgia Insurance Commissioner John Oxendine has approved four

such provider corporations -- the latest in Savannah -- and is

looking to expand the idea into areas that have only in recent

years begun to get a taste of managed care.

Doctors and hospitals see it as an opportunity to run their

business without interference from insurers, who control the

health maintenance organizations.

"This way, we have some say so. There won't be drive-through

deliveries, drive-through mastectomies," said Sammie Dixon,

president of PartnersChoice Health Corporation, from his office

at Tift General Hospital in Tifton.

PartnersChoice was the first of four provider-sponsored health

care corporations to win Oxendine's approval in the past year.

The others are Evergreen Health Plan Inc., in Columbus; Secure

Choice Health Plan Inc. in Atlanta; and Memorial Medical

Center's ProHealth Inc. in Savannah.

Other hospitals are considering applying for a license to

operate the HMO-like businesses, but Oxendine wouldn't name any

of them.

The commissioner said the new corporations give Georgians,

particularly those living outside Atlanta, more choice in buying

health coverage.

"They [HMOs] had a monopoly before," Oxendine said. "Now they

have competition. Now you've got competition in managed care.

The consumer only benefits from that."

So, potentially, could taxpayers, because the hospital-based

programs might be able to put Medicaid and Medicare patients

they treat into their managed care plans, saving money.

Managed care companies, especially HMOs, have been growing

wildly in Georgia during the 1990s. About 1 million Georgians

now are enrolled in HMOs. Last year, Georgia's HMOs took in

$1.27 billion in revenue.

Most of the 1 million enrollees live in the Atlanta area, but

HMOs have rapidly expanded to other cities. …