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The report came at a delicate time for the managed care industry, which is being encouraged by Congress to play an increasing role in serving the nation's 38 million Medicare beneficiaries. Spokesmen for many H.M.O's have complained in recent months that the Federal Government does not pay them enough to care for Medicare patients, but this and other studies suggest that in some cases the organizations have been paid too much.
The inspector general, June Gibbs Brown, said many H.M.O.'s profited ''excessively'' from Medicare, because they billed the Government for administrative costs attributable to their private commercial customers as well as their Medicare patients.
In short, Ms. Brown said, H.M.O.'s have received ''an unreasonable amount'' from Medicare because their administrative costs were grossly inflated, by a total of $3 billion to $4 billion in the three years of financial reports that she reviewed.
Nancy-Ann Min DeParle, administrator of the Health Care Financing Administration, which runs Medicare, responded that her agency was making changes to reduce overpayments in the future. But in a written response to the inspector general, Ms. DeParle disagreed with the recommendation that she seek legislation allowing Medicare to recover the excess payments.
Ms. DeParle said that the overpayments helped H.M.O.'s finance extra benefits for Medicare patients, and that that was apparently what Congress intended. If Medicare payments to an H.M.O. exceed the cost of the standard package of benefits, the health plan can use the money to provide extra benefits like prescription drugs dental care and foot care.
But the inspector general said there was evidence that H.M.O.'s had not provided all the extra benefits they indicated in their annual reports to the Government. Still, Senator Charles E. Grassley, Republican of Iowa, the chairman of the Special Committee on Aging, urged the Administration to try to recover the overpayments. ''Can't we get back that money for the trust fund?'' Mr. Grassley asked.
H.M.O.'s say that if the Government cuts their payments for administrative and other costs, it will be more difficult for them to offer extra benefits, like eye care and prescription drug coverage, which have attracted elderly people in the past.
Ms. Brown, the inspector general, said the overpayments were cause for concern because of the precarious financial condition of the Medicare program, which finances health care for more than 38 million people, including 6 million in H.M.O.'s. Under current law, with no action by Congress, the Medicare trust fund is expected to run out of money in 2008.
Administrative costs include marketing, taxes and profits, salaries and fringe benefits, rent, depreciation, interest expenses, data processing, legal fees and other overhead costs associated with the management and operation of an H.M.O.
Examining the financial records of H.M.O.'s with Medicare contracts in 1996, Ms. Brown found that Medicare paid 31.7 percent of their administrative expenses, but accounted for only 8.9 percent of their enrollment.
Medicare payments to H.M.O.'s have grown significantly, to $25.6 billion last year from $8.6 billion in 1993. The Congressional Budget Office predicts that 10 million beneficiaries, will be in H.M.O.'s by 2002.
Congress is encouraging the trend, in the belief that the organizations can help control costs in the long run. But some H.M.O.'s have pulled out of the program, saying Medicare payment rates are inadequate. The United Healthcare Corporation, one of the nation's biggest H.M.O.'s, took a $900 million charge against earnings last week, in part to abandon unprofitable Medicare plans.
Ms. DeParle agreed that H.M.O. accounting techniques had ''almost certainly resulted in overstated administrative costs.'' But she expressed concern about possible cutbacks in benefits.
''We have received reports that some H.M.O.'s have reduced benefit levels and increased premiums'' for Medicare patients this year, she said, and ''it is possible that beneficiaries will again experience reduced benefit levels'' in 1999.
For years, Medicare has operated on the principle that it should pay its share of costs for various services.
Ms. Brown found that the administrative costs assigned to Medicare were more than three times the amounts that H.M.O.'s charged to commercial customers, even though ''a large portion of administrative costs are fixed'' and do not vary with a patient's age. In 1997, she said, the average monthly H.M.O. premium for administrative costs was $20.87 for commercial customers and $77.30 for Medicare patients.
IT speed is necessary to respond to new competitors and to enter new markets—in addition to launching new products and services.
70% of global execs said the rate of business/tech change has increased and that they expect this increase to continue for the next three years.
63% said their organization responds too slowly to tech opportunities.
59% said "handoff breakdowns" in attempting to deliver a new tech capability occur within business, finance, legal and/or external parties, while 41% said this happens within the IT department.
84% said IT speed is needed to help their organization comply with new laws and regulations, and 80% said IT speed plays a critical role in responding to changes in demand.
79% said IT speed is required to respond to new types of competitors, and 77% said it's needed to enter new markets as well as launch new products/services.
48% said they'd be willing to compromise on cost, quality or functionality for greater speed.
81% said their organization lacks a formal statement defining its risk appetite.
To "get things done" quickly, make sure "speed" roles are assigned to highly capable and accountable people—and give them authority to make fast decisions.
Some stakeholders hesitate to bring in IT to avoid having their proposal "locked down" due to perceived tech issues. But looping IT in early will ultimately save time later.
Best Practices: Plan for "Speed to Value"
Don't simply work fast to implement a new technology—work fast to implement a new technology that will create instant and measurable value.
Business and tech executives said the swift pace of business and tech changes will only continue to increase for the foreseeable future—and that their organization responds too slowly to these shifts, according to a recently released survey from CEB. The resulting report, titled "Executive Guidance for 2016: Accelerating Corporate Clock Speed," indicates that there's plenty of blame to go around for these delays, as "handoff breakdowns" occur within IT, business, finance, legal and outside vendors and third parties. Such snags need to be overcome, lest companies fall behind in entering new markets, keeping up with new competitors and addressing regulatory requirements. "Enterprises must move faster to stay competitive and to manage emerging risks, and technology is increasingly the rate-determining factor,'' according to the report. "To ensure that technology clock speed accelerates rather than inhibits corporate speed, business leaders must create faster, more streamlined handoffs between all the groups involved in delivering new technologies. They need to streamline processes and methodologies so that most technologies are fast-tracked while the few that are risky or expensive get the scrutiny they deserve … These actions cannot be left to the CIO or to technology vendors and consultants. All members of the leadership team must recognize how their decisions and demands influence speed." More than 3,260 global executives took part in the research. The report includes additional research from MIT Sloan Management Review and other publications and organizations, and we've included some of those findings here.
The Highland County Poultry Pigs & Lambs 4-H Club met on Sunday, July 8 at 2 p.m. at the Hamer Township House. There were 13 members and three Cloverbud members present for the meeting.
Demonstrations were given by Riley Meek and Noah Freeling.
The adviser went over upcoming dates and deadlines. The 4-H summer judging is July 10, special interest judging for the Ohio State Fair will be July 11 and the Summer Awards/Style Review will be on July 12. Entry day will be on July 20 at the fairgrounds from noon until 6 p.m. Poultry Meat Pen chicks are to be picked up at the fairgrounds on July 26 from 6:30 to 8 p.m.
The adviser encouraged members to participate in the skillathon tests at the Ohio State Fair and Highland County Fair. Members will be able to practice with the skillathon kits on July 2 and the Aug. 12 meeting. Members will receive their fair wristband when they complete their eighth meeting.
The next meeting will be held at 2 p.m. Sunday, Aug. 12 at the Hamer Township House. The meeting was adjourned and refreshments were served by Riley Meek.
Submitted by Matthew Gossett, 4-H club news reporter.
New York: Tycoon Warren Buffett’s Berkshire Hathaway has agreed to buy $5 billion of stock in Goldman Sachs, and could double its stake within five years, the Wall Street bank said late on Tuesday.
Under the terms of the agreement, Berkshire Hathaway is buying $5 billion of perpetual preferred stock bearing a 10% annual interest rate, Goldman Sachs Group said in a statement.
Buffett, through his holding company, will have the option of buying $5 billion of common stock priced at $115 a share “at any time for a five-year term," the company said.
Goldman Sachs, until Monday one of the last two major Wall Street investment banks, with Morgan Stanley, said it plans to raise “at least" $2.5 billion in common equity in a public offering.
Goldman Sachs said it had struck the deal with Berkshire Hathaway “in a private offering."
“We are pleased that given our longstanding relationship, Warren Buffett, arguably the world’s most admired and successful investor, has decided to make such a significant investment in Goldman Sachs. We view it as a strong validation of our client franchise and future prospects," Lloyd Blankfein, Goldman chairman and chief executive, said in the statement.
In electronic trading after the stock market closed, Goldman Sachs shares leapt 8.12 % to $135.20.
“Goldman Sachs is an exceptional institution," Buffett, chairman and CEO of Berkshire Hathaway, said in the statement.
Monday, the Federal Reserve approved applications from Goldman Sachs and its Wall Street investment bank rival Morgan Stanley to become bank holding companies, effective immediately, amid a worsening financial crisis.
The conversion of Goldman Sachs and Morgan Stanley to regulated commercial banks marked the end of an era of independent Wall Street investment firms and a separation in the industry since the 1930s.
The change closed the door on the last two major Wall Street firms as independent, largely unregulated entities.
The investment banks began falling with the demise of Bear Stearns in March, which had to be rescued by JPMorgan Chase at a bargain-basement price from a death spiral because of its massive losses from a real-estate meltdown.
Earlier this month, investment bank Lehman Brothers filed for bankruptcy when it failed to find a partner or government aid, and rival Merrill Lynch was forced into a marriage with Bank of America.
Goldman and Morgan Stanley had been the last two major independent Wall Street banks, but had been under intense pressure to find merger partners in the face of financial market storm on fears of further collapses in the sector.
READY! SET! BUILD! New, modern construction can be made worth a fortune building in this location. Enjoy the 4th of July fireworks from your backyard with a nice view of the downtown skyline. Walking and biking distance to local downtown amenities and be anywhere in minutes, and with easy access to the interstate be anywhere in Indy quickly! Downtown is hot and expanding fast. Get in on the action while you can still get a steal on this location. You can set the tone for this area and make it your own. Others will follow and your value will go up up up! This area will soon be unrecognizable as downtown revitalization continues its rapid expansion in all directions. Time to go for it!!!
that oil demand in quake-ravaged Japan will slow.
tandem with oil prices because Canada is a major oil exporter.
earthquake and tsunami in Japan.
it's been in for most of the past two weeks.
the U.S. dollar, or $1.0298.
capacity-utilization rate in the fourth quarter.
first for which the market is fully pricing in a rate increase.
BMO's Guatieri said he expected no change in the U.S.
program that is intended to bolster the U.S. economy.
The early entry list for the 2017 NFL draft is mostly finalized, so it's that time of year again -- time to take an initial look at how the SEC West might shake out this fall.
We're still a couple of weeks from signing day and a couple of months from spring practice, but obsessing about the next football season is kind of what we do around here. So how's the SEC West looking for 2017, a mere 8 1/2 months from the season-openers?
1. Alabama: The king stays the king until someone proves otherwise, and the Crimson Tide is no exception. Alabama has to replace a ton of front-line talent on defense, but returns its entire backfield and most of its line on offense.
2. LSU: The Tigers are the only team in the division that can match up talent-wise with Alabama, though they lose a good bit of depth due to early entries. We'll see what kind of difference new offensive coordinator Matt Canada makes.
3. Auburn: The Tigers took a decent step forward in 2016 and got a big boost from the signing of Baylor transfer Jarrett Stidham to play quarterback. However, questions remain about the offense's direction, with a new coordinator still to be hired.
4. Texas A&M: The Aggies have collapsed in November for three straight years now, putting Kevin Sumlin firmly on the heat seat heading into 2017. There's still enough talent in College Station to avoid a total meltdown, though.
5. Mississippi State: The Bulldogs are one of just two SEC teams that head into 2017 with a two-game winning streak (LSU is the other). Quarterback Nick Fitzgerald looks like a keeper, but MSU must replace seven starters on defense.
6. Arkansas: The Razorbacks were horrible on defense and soft on the lines last season, which is a horrible trend in Bret Bielema's fourth season. It's possible Arkansas bounces back in 2017, but things are trending the wrong way.
7. Ole Miss: Things could be on the verge of falling apart in Oxford, where the NCAA specter continues to loom following a 5-7 season. Quarterback Shea Patterson looks like the real deal, but the Rebels will have new coordinators on offense and defense.
So there's one predicted order of finish for the SEC West in 2017. What's yours?
I'll take your comments and questions on that and anything else on your mind beginning at 10 a.m.
Cody Michaels has been playing volleyball for her entire life. From practicing her serves at backyard picnics to starting for Quinnipiac at Burt Kahn Court, Cody has always held the passion close to her heart.
Volleyball isn’t her greatest passion, however. Her real focus lies some 650 miles away in the city of Lexington, Ky. It isn’t in the form of a sport, or through art or music.
It’s in welcoming neglected children to her home.
Cody is a foster sister. She and her parents have been admitting mistreated children to their home since her sophomore year of high school. Since Cody was 13, the family has taken in about eight placements, admitted for a variety of reasons.
“They’re kids that have been neglected, abused that need a place to go,” Cody added.
Karen Michaels, Cody’s mother and a licensed therapist, established the program to help children in need.
The Michaels family received its first placement during Cody’s sophomore year of high school. The practice has continued since, despite Cody residing away at school and her status as a Division I athlete.
Karen praised Cody for being so passionate about her involvement in foster care.
Although the Michaels family has housed about eight placements in the past four years, the process of holding children is not continuous or consecutive.
Currently, the Michaels family only has one placement, who has been residing with the family for two years following abuse at home.
Cody has been an only child for her entire life, and not once did the thought cross her mind about having a sibling.
“Having her in my life for the past two years, I can’t imagine life without her,” Cody Michaels said.
Cody recalls other instances of spending time with the family’s placements, including one occasion when the Michaels took in a young baby.
In crediting her desire to become involved in foster care, Cody points to her mother.
Attending Quinnipiac and competing for the women’s volleyball team this fall, Bobcats head coach Kristopher Czaplinski has seen Cody’s dedication transition from her foster home to the court, even as a young freshman.
Though Czaplinski never saw Cody play in person prior to her collegiate career, the second-year head coach knew he was witnessing something special in the 5-foot-2 libero.
This season, Michaels has totaled 37 digs in 10 matches, good for third on the team. Michaels is also one of only three freshmen to play in every match this year.
Although Michaels has already enjoyed success for the Quinnipiac women’s volleyball team during her young career, she already has an idea of what her future holds; in this case, opening up her own home to those in need.
"Perfect Porterhouse"--dry aged prime strip steak/petite filet mingnon/bone marrow/black garlic persillade--at Alexander's in San Francisco, Calif., on Thursday, January 20, 2011.
Can the space which housed Bacar - a visible symbol of the late 1990s dot-com boom - be revived? It's certainly the hope of the new tenants - Alexander's, the Cupertino steak house that garnered a Michelin star last year. In September, the owners opened this South of Market location.
While the expansive warehouse space has much the same look, with the sleek wine wall at the entrance, exposed brick and warehouse windows, it's been rejuvenated; the look is more cohesive and finished. Acoustic tile, new carpet and tablecloths have helped to marginally muffle the once boisterous sound and make the dining experience more pleasant.
However, as I opened the menu and saw the prices, the only sound I heard was my own gasp. More than half the steaks are above $50.
I should have been prepared because at a steak house you know you're going to be paying prime money for prime meat, but this is really top dollar. In the end, it's the bells and whistles that distinguish a steak house by bringing customers in and keeping them coming back. While there was much to like about Alexander's, I'm not sure I'd give it a ringing endorsement.
Appetizers, steaks and sides have Japanese overtones, and at times this connection can seem forced. The raw fish in the hirame sashimi ($15), for example, should have been the star, but it became a supporting player to a dusting of pepper, dollops of reduced balsamic, scatterings of micro-greens, puddles of a red pepper and quarter-size rounds of mosaic-like maki. It was pretty and tasted good if you didn't mind that the delicacy of the fish was obliterated.
Presentation trumped execution in the warm chicory salad with lentils ($12) that served as a base for greens, overly generous chunks of pancetta and a runny egg yolk. I liked the contrast of cool and warm, but the flavors didn't seem to come together, something that also characterized other dishes.
Many seemed overloaded with embellishments, muting the main ingredient, such as sweetbreads ($16). They were expertly sauteed, then set atop three pools of onion puree with oxtail and red lentil ragout, accented with a translucent cracker made of dehydrated onions. While this added an interesting artistic element, it had the consistency of fruit leather and annoyingly stuck to the teeth.
More Japanese influence is seen in several raw-fish dishes, including bigeye tuna sashimi ($14) accented with citrus spheres, fennel ponzu, tarragon and olive oil powder. A few steak house staples round out the offerings, including Caesar salad ($11) and the iceberg wedge ($10), in this case dressed up with eggs, celery, bacon, blue cheese and Fuji apple.
The heart of the menu is the steak, of course, and many are enhanced with various herbs and sauces. A grilled filet mignon ($38 for 6 ounces/$44 for 10 ounces) is accented with dried green olives and a black olive hollandaise. A bone-in 24-ounce New York steak ($52) has brandied peppercorn sauce.
The 8-ounce fire-roasted tenderloin ($42) comes with kimchi butter, a Japanese spice rub and sesame salt. I wasn't expecting the half cup of chunky sauce, thick with peppers and other seasonings, that doused the meat. It masked the taste of a very nicely cooked steak. The same thing happened with the 12-ounce dry-aged prime strip steak ($55); the meat was good, but the truffle sauce poured over it had distractingly sweet elements.
I'd go back for the slab of prime rib ($37 for 14 ounces, $42 for 20 ounces). It was beautifully marbled, served with natural juices and three kinds of horseradish: one with beets, one creamed and a third with wasabi. That's really all you need.