Doc practice management set to explode.

An industry that barely existed give years ago is emerging as a prime mechanism to organize doctors. Independent physician management companies are uniquely situated to do the job as HMOs rethink the strategy of employing physicians and as hospitals find doctors reluctant to come under their control.

Price bundling packs pitfalls.

Hospitals thought bundling of healthcare services under one all-inclusive price would have great appeal to payers, bringing in more business. But instead, the concept has brought disappointment as the expected boost in patient volume has failed to materialize.

Docs try to own managed care.

Fed up with big for-profit HMOs, physicians across the nation are forming plans, sometimes with the help of state associations, as they try to own managed care. However, the sale of an HMO that services as a model for other doctors fuels industry doubt.

PHOs fall short of expectations. Despite failings, networks may have role as a transition to vertical integration.

An estimated 3,000 physician-hospital organizations have formed since the early 1980s, most of them in the last two years. But their slow progress in managed-care contracting has many wondering if they're anything more than an expensive fad. Proponents argue that despite their failings, PHOs may have a role as a transition to vertical integration.

PPMs on the rebound. Companies learn from mistakes, develop new strategies.

Physician practice management companies, once Wall Street's darlings, are now running into the reality of risk contracts and declining reimbursements. Those and other roadblocks have reduced profits to a rumor for many companies. As a result, the industry is being forced to change its core strategies, while some observers even question whether PPMs will survive as relevant players.

Doc accrediting goes high-tech.

Physician credentialing, an obscure but critical process that serves as the primary safeguard against poor care is undergoing a high-tech revolution. A handful of credentials verification organizations are bringing efficiency to the labor-intensive chore by consolidating most of the required data. Technology can expedite physician approvals for managed-care panels and hospital privileges.

Will PSOs be a disaster or a dream?

The healthcare landscape is littered with failed attempts by hospitals and physicians to manage insurance risk. This year's survey of managed-care plans shows 12 of 30 provider-owned HMOs lost money in 1997. And Modern Healthcare's news pages have chronicled recent losses at more than 20 provider-owned plans. With provider-sponsored organizations in the pipeline, the question is: Will they be a dream or are they a disaster in the making?

Staying single.

Can single-specialty group practices survive in managed-care markets? Specialists are seeking strength in large practices, which are better positioned to shield themselves from abrupt shifts in managed-care provider lists and to resist exclusive deals with hospitals.

A deal that's hard to refuse. Physicians use clout to win joint ventures with hospitals despite fiscal perils.

Just as many hospitals rid themselves of unprofitable medical practices, a risky new strategy to win physician loyalty is gaining popularity: hospital-physician joint ventures. Some analysts say the deals could backfire, as the dangers for hospital balance sheets outweigh the benefits.

On balance, a positive outcome.

Picking up the pieces after a broken marriage can be painful, but the split can be beneficial. A review of a half-dozen failed mergers shows that divorce carries a price, but ultimately the former partners believe they will be stronger operating independently and can do a better job serving their communities.

No boundaries. Texas' Christus Health bucks trend by looking to Mexico for expansion.

Christus Health has bucked the trend by looking to Mexico for expansion. The Roman Catholic system based in Irving, Texas, bought 51% of Hospital Muquerza in the prosperous northern Mexico state of Nuevo Leon. Christus believes the move makes sense on many levels.

This side of the ethical border. Hospitals feel duty of keeping immigrants healthy despite federal limits.

Healthcare for undocumented residents has become an explosive issue in Texas. Under disjointed federal law, many immigrants are not entitled to benefits under Medicaid unless there's an emergency. Because of a state official's ruling, public hospitals that have been treating immigrants now could face criminal charges.

Wanted: a few good leaders. Hospital systems try to improve the top ranks.

Just when hospitals and healthcare systems need highly qualified leadership the most--considering all the management challenges the industry continues to face--there seems to be a growing shortage of skilled executives. A handful of industry executives are working with provider organizations and the nation's graduate programs in healthcare administration to develop a plan to re-engineer the training and development of future leaders.

Physicians find power in unions.

A growing number of physicians are using organized labor to gain economic leverage. Hospital downsizing and autocratic managed-care plans have prompted more doctors to join the ranks of other professionals who carry union cards. While not a sweeping trend, interest in unions is growing--even among private-practice physicians who can't bargain collectively because of antitrust laws.

As more and more doctors join physician groups, antitrust experts wonder whether hospitals and health plans will be ... outgunned.

To increase market leverage, more doctors are forming networks. That's setting off alarms among economists and antitrust experts who say such organizations are mushrooming without proven benefits for consumers. Some argue that more areas of the country could be saddled with monopolies that stifle competition. Hospitals and health plans fear physicians' new power could leave them outgunned.

Branding time at Columbia.

This week Columbia/HCA Healthcare Corp. introduces a national advertising blitz believed to be the largest ever by a healthcare provider. The hospital giant wants to instill its brand name in the American lexicon, and it's willing to spend millions to do so.

Buying doc practices often leads to red ink.

Like impulsive shoppers, hospitals can't seem to buy enough doctors. However, hospital-based systems aren't prepared for the management challenges of running medical groups. Many have been plagued by productivity slumps and high operating costs.

Internet technology moves to patient-care front lines.

Hundreds of home pages--many of which amount to electronic marketing brochures--have marked healthcare's first tentative steps onto the World Wide Web. Now, a few innovators are taking Internet technology to the front lines of patient care.

Healthcare ads getting aggressive.

Contrary to some expectations that managed care would negate consumer advertising, it has instead increased competition in many markets, forcing providers to sell themselves more aggressively. Some hospitals' marketing strategies have competitors crying foul.

Remembering the specialists. After spending billions on primary-care networks, hospitals are cozying up to top revenue generators.

After hospitals and practice management companies spent the better part of this decade snapping up primary-care doctors, they suddenly remembered the specialists. You know, those guys in white coats who generate much of the revenues.