National Managed Care Firm Implements Program Designed to Aid Ailing Health Plans.

NEWTON, Mass.--(BUSINESS WIRE)--March 29, 1999--Responding to the recent publicity in the national press surrounding takeovers, liquidations, and financial troubles of health plans, Barry Scheur, President of Scheur Management Group (SMG) announced the implementation of the firm's MCORE (Managed Care Operations and Revenue Enhancement) Medical Management program.

Scheur noted the recent seizure of MedPartners Provider Network by the state of California as a symptom of a national epidemic affecting physicians' provider networks, hospital-based health plans, and HMOs. Scheur states, "rising costs, lower reimbursement rates, aggressive expansion and, in some cases, mismanagement, are issues leading to the demise of health plans leaving consumers without promised quality healthcare delivery. Using the combined expertise of our senior consultants who specialize in medical management, we have created a dynamic program to assist networks and health plans in attaining and maintaining quality standards of care, operational stability, and revenue enhancement."

Scheur notes that MCORE's focused three-day assessment, evaluation, and intervention program is an innovative and efficient way for plans to get an appraisal of their problems. He states, "In just a few days, we can determine the 'health' of the plan, offer insights, recommendations, and a realistic blueprint towards solvency and quality. Most important, we offer sound solutions to the identified problems." Scheur announced that the MCORE program will be directed by Dr. Paul Reich who stated, "Health plans and medical groups more than ever need programs to support their medical management efforts. I look forward to being part of an expert team working with plans and groups to target areas for improvement as we design and implement the needed revenue enhancement solutions that will appropriately control rising medical and pharmacy costs."

Dr. Reich, noted columnist for Managed Care Interface, was previously Medical Director for Pilgrim Health Care where he played a major role in Pilgrim's successful network expansion, providing medical management leadership as Vice President for Medical Affairs. In addition, he received certification as a site surveyor for the National Committee on Quality Assurance (NCQA). A Diplomate of the American Board of Medical Management, Dr. Reich served as a mentor for the American Association of Health Plans (AAHP) Executive Leadership Program which trains HMO medical directors and administrators.

Other members of the SMG team of specialists, with over twenty years of expertise each, include Catherine Hill, a former COO and CEO of major HMOs whose experience includes organizational policy and procedure, network development, claims management, quality improvement and customer service delivery; and Robin McElfatrick, with expertise in HMOs, indemnity plans, organizational analysis, operations, medical management, MIS assessments, claims and coordination of benefits.

Scheur Management Group is a Massachusetts-based, nationally recognized managed care consulting firm serving the full spectrum of healthcare clients, from HMOs and other managed care organizations, physician group practices, hospitals and PHOs, to healthcare product and service companies and government agencies.