DHS to oversee NYLCare Medicare HMO

MARYLAND WATCH

September 19, 1997

Already the largest physician group in the state, Doctors Health System is also moving into the business of overseeing care given by other doctors, as it announced yesterday a three-year contract with NYLCare Mid-Atlantic to manage care for its Medicare HMO.

NYLCare will pay DHS a fee per member, leaving DHS responsible to pay for as well as oversee all care. "This makes Medicare dollars much more flexible," said Dr. Scott Rifkin, chairman of DHS. With this flexibility, he said, his group hopes to keep down medical costs by an elaborate program of preventive care -- for example, by providing scales to monitor the weight of elderly patients in danger of heart failure.

Some of that care will be delivered by the more than 500 primary care doctors who are members of DHS. For non-DHS doctors who are in the NYLCare network, "we put the protocols [care guidelines] in place, and the doc takes care of the patients," Rifkin said.

That type of management has generally been done by medical directors and other staff working for HMOs. Rifkin said DHS is currently exploring other care management contracts.

Pub Date: 9/19/97

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