In Texas Tuesday there was a landmark settlement that could be a model for reforming HMOs and other managed healthcare plans nationwide. CBS News Correspondent Maureen Maher examines the settlement terms to see what they will and won't change, and explains the possible wider impact. Some of the things that insurance companies were dictating to us were getting in the way of the quality care for patients, says Winter. Many physicians are especially critical of programs that reward doctors who keep the cost of treatment down and penalize those who don't.
Patients contend the practice leads to inadequate care.
The deal prohibits Aetna from fining doctors who exceed medical budgets or rewarding those who come in under. In exchange Aetna admits no wrongdoing and will not pay any fines. It'll make it easier for patients to deal with problems they have. Still, it's a step that more and more HMOs may be willing to take, considering how the managed care industry has come under attack and with Congress looking at a patients' bill of rights, plus the number of class action lawsuits still pending. Tom Brown, Aetna regional manager, says the agreement would not force the HMO to increase costs.