Managed Care Contracting

Managed Care Contracting
Author: William A. Garofalo
Publisher: Jossey-Bass
Total Pages: 0
Release: 1999-01-06
Genre: Health & Fitness
ISBN: 9780787945817

Today's heath care marketplace is highly competitive, requiring managed care providers to contract with dozens of insurers to survive. Each of these contracts comes with their its unique terms and conditions-making the contracting process overwhelmingly complex and giving many health care executives major headaches. Written by three of the country's leading health care consultants and attorneys, Managed Care Contracting is the first book to offer executives with no legal background practical, step-by-step advice on how to create winning contracts between health care organizations, payers, and employers. In straightforward language, free of legalese and jargon, this much-needed resource demystifies managed care contracting and prescribes some critical advice for hospital and physician group practice executives. The authors present helpful guidelines for evaluating the various types of managed care contracts and explain the most significant terms and concepts executives are likely to encounter. A treasure trove of information for health care executives no matter what their experience level, Managed Care Contracting Examines how to develop a contracting strategy Reviews the fundamentals of negotiating the contract Frames the key steps in the contracting process Provides a managed care contract negotiations checklist Dissects sample hospital and physician contracts Analyzes the contract risk factors by the type of payment explores the implications of changing financial incentives Outlines the most up-to-date information in the regulatory environment Includes illustrative examples and helpful tables and chartsFor health care executives who are just beginning the complex contracting process and for the more experienced who require the most current information on the topic, Managed Care Contracting provides the knowledge and tools they need to succeed. "Managed Care Contracting is a very timely

Managed Care Contracting

Managed Care Contracting
Author: Wendy Knight
Publisher:
Total Pages: 392
Release: 1997
Genre: Managed care plans (Medical care)
ISBN:

This book provides physician executives and medical group managers with a 'next generation' reference on the managed care contracting process. This handbook will educate health care providers about managed care contracting: how the contracting process works, what a standard practice contract looks like and why certain provisions are included, what questions to ask and how to evaluate a capitation rate. Provides pertinent information from professionals in the field.

Positioning Your Practice for the Managed Care Market

Positioning Your Practice for the Managed Care Market
Author: J. Thomas Danzi
Publisher:
Total Pages: 260
Release: 1996
Genre: Managed care plans (Medical care)
ISBN:

A physician's survival guide for adapting a medical practice to the managed care environment. Reviews major issues in health care reform, defines managed care, and discusses financial and clinical assessment of an individual practice for the managed care market, looking at managed care from the perspective of the provider, the medical doctor, and the medical student. Other topics include quality improvement; legal implications of managed care; and IPOs.

Managed Dying

Managed Dying
Author: Barbara Johanna Janesick
Publisher: Xlibris Corporation
Total Pages: 0
Release: 2000-06
Genre: Health maintenance organizations
ISBN: 9780738819105

Managed Dying - An HMO Survival Guide This guide is to assist people to contend with the rapidly growing managed care business that is predominating the health care delivery system in United States. The HMOs manage people as dollar signs, while short changing them with sometimes inadequate and delayed medical treatments. This is a significant change in how patients were conventionally treated years ago. Because of these cost cutting trends, people need to be informed about HMO performance, how to become advocates within the system, and how to receive the best medical care possible by a for-profit managed care corporation. It is hoped that readers will become more educated to prevent personal tragedy before it happens and be given new insight and perspective about the corporative world of HMOs. The guide will show the only way to beat the system is by members keeping abreast of their health plan policy, being informed about the illness, becoming active in their own medical care, and ensure their patient rights are never violated. Readers will learn how to become an HMO survivor when faced with a chronic and serious disease. The book enlightens people about the silent medical crisis that is occurring nationally to our health care system. It provides the tools to become an effective advocate for themselves or a loved one. Every HMO member should be knowledgeable about the managed care, because the time will come when a family member is hospitalized and has to face the bureaucracy of the HMO provider. Managed care physicians will not always go to bat for a patient due to his or her contract restrictions. The public must realize the “Marcus Welby” days are a past compassionate tradition that has disappeared. The guide provides an internal look at the system and offers key strategies and options when seeking proper and efficient medical treatment.

The Psychiatrist's Guide to Managed Care Contracting

The Psychiatrist's Guide to Managed Care Contracting
Author:
Publisher: American Psychiatric Publishing
Total Pages: 92
Release: 1997
Genre: Medical
ISBN:

Because of growing enrollment in managed care plans, psychiatrists are finding it necessary to sign contracts with managed mental health care programs in order to receive third-party payment. These contracts often lead to complications and form a key area of concern for clinicians. The Psychiatrist's Guide to Managed Care Contracting helps psychiatrists make sense of the legal issues arising from their managed care contracts. In a step-by-step manner, this useful guide develops the framework for the crucial decisions that must be made and highlights the strategies a psychiatric practice can employ to shape the contract in its favor. It reviews standard contract provisions and the issues involved so that potential problems can be identified early in the negotiating process. The Psychiatrist's Guide to Managed Care Contracting also details the essential groundwork and preparation that should be completed before a psychiatric practice enters negotiations, including practice assessment, financial planning, marketing, and the development of administrative support. Equipped with this knowledge and advice, psychiatrists can negotiate from a position of strength and develop a favorable contract that ensures the survival and prosperity of their practice.