LYCOS RETRIEVER 
Humana: United States
built 605 days ago
To build its medical reputation, Humana established a Centers for Excellence program in 1982 for the purpose of specialty care. This included centers for neuroscience, diabetes, spinal injuries, and artificial-heart research and surgery. The artificial-heart projects--which were undertaken partly for the publicity they generated--helped push Humana's name into public view. In 1982 Humana had 90 hospitals, primarily in the sunbelt states. Humana ... leased and operated the University of Louisville's teaching hospital, where Jefferson County, Kentucky, citizens without the ability to pay for hospital care received inpatient treatment for no charge--state, city, and county governments covered the costs.
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The work of Humana is widely acknowledged. It is supported by many national and international organisations among which are UNICEF, the Finnish Ministry of Foreign Affairs, the Dutch Ministry of Development Cooperation, the Spanish Ministry of Foreign Affairs, the Ministries of Education in Angola, Mocambique, Namibia and Zambia, the OPEC Fund for International Development, the European Commission Delegation in Zimbabwe and the Arab Gulf Fund for United Nations Department Organizations (AGFUND).
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The Smeliks alleged that the care delivered by Humana and its physicians to Joan Smelik was substandard. Testimony showed that Mrs. Smelik had been under case management when Humana had outsourced that service to another health care provider. But when that contract ended and Humana began handling case management on its own, Mrs. Smelik's case was not given the necessary extra oversight. Previously, employer based HMOs' denial of health care benefits had been largely shielded from regulation by state legislatures with the Supreme Court decision in Aetna v. Davila. Now, the Smelik verdict empowers individuals to fight against HMOs when the HMOs are focused more on saving dollars than on saving lives.
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Joining approximately 160 participants at its Chicago meeting were sponsors: Jefferson Pilot Financial, Employers Reinsurance Corp., United Healthcare, Colonial Supplemental, Humana, Pharmacare, and Trustmark Insurance. "It's easy to see why United Benefit Advisors has grown so quickly as an organization," said Joel Suarez, Senior Vice President, National Sales & Account Management for United Healthcare. "When so many of the nation's leading employee benefits firms work together, the customer wins."
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Humana unloaded unprofitable hospitals. While the healthcare industry was burgeoning into the second largest industry in the United States, Humana alone was honing its cost controls: between its own growth and government-subsidized medical care, the industry in general had not yet felt the need for cost efficiency.
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Austin Provider Solutions will receive processed summary data of diabetes-related medical claims submitted by DFW area physicians from the five participating health plans -- Aetna, Blue Cross and Blue Shield of Texas, CIGNA, Humana and UnitedHealthcare. APS will aggregate the summary data across all five health plans to produce a single set of health care performance ratings for each physician.
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