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Author : Anonim
Publisher : Unknown
Page : 58 pages
File Size : 49,9 Mb
Release : 1990
Category : Electronic
ISBN : 0872585433
Author : Maurice J. Penner
Publisher : Maurice Penner
Page : 298 pages
File Size : 45,9 Mb
Release : 1997
Category : Capitation fees (Medical care)
ISBN : 1567930514
This "from-the-trenches" guide can help you meet the challenges of forecasting a population's healthcare needs, building a provider panel, establishing financial incentives for providers, establishing information systems for managed care, negotiating managed care contracts, & managing utilization & quality.
Author : David Edward Marcinko
Publisher : Jones & Bartlett Learning
Page : 372 pages
File Size : 52,7 Mb
Release : 2005
Category : Insurance
ISBN : 0763733423
This book fulfills its promise as a peerless tool for physicians wanting to make good decisions about the risks they face.
Author : Barbara J. Youngberg
Publisher : Jones & Bartlett Learning
Page : 306 pages
File Size : 42,6 Mb
Release : 1995
Category : Health facilities
ISBN : 083420732X
The dominance of managed care is spreading quickly and risk managers are suddenly faced with major new challenges. With Managing the Risks of Managed Care, the risk manager will learn about risk management challenges in an integrated delivery system. The book also presents expert analysis on issues like contracting, peer review, ethical dilemmas, antitrust and more.
Author : RiskCare Staff,Fay A. Rozovsky
Publisher : Unknown
Page : 100 pages
File Size : 47,9 Mb
Release : 1999-08
Category : Electronic
ISBN : 1893929116
Author : George B. Moseley
Publisher : Jones & Bartlett Learning
Page : 644 pages
File Size : 40,8 Mb
Release : 1999
Category : Group medical practice
ISBN : 0834207354
This book is a guide to strategic training for physicians in an era of managed care. The first half of the book provides a step-by-step process to help physicians take their practices into the new world of integrated delivery systems. The second half of the book covers a variety of key topics such as credentialing, reimbursement systems, and utilization management.
Author : William A. Garofalo,Eve T. Horowitz,Thomas M. Reardon
Publisher : Jossey-Bass
Page : 0 pages
File Size : 52,7 Mb
Release : 1999-01-06
Category : Health & Fitness
ISBN : 0787945811
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
Author : William N. Tindall
Publisher : Jones & Bartlett Learning
Page : 322 pages
File Size : 45,5 Mb
Release : 2000
Category : Managed care plans
ISBN : 0834217651
Provides physicians, administrators, and other health professionals with information on managed care, from its history, forms and practices to detailed information on managed care contracting, physician compensation, monitoring, reporting, management, risk, productivity, and accountability. Annotati
Author : Kay Stanley
Publisher : Amer Medical Assn
Page : 158 pages
File Size : 42,5 Mb
Release : 2004-01-01
Category : Medical
ISBN : 1579472931
Now is the time to make sure managed care doesn't manage you. This resource provides an overview of today's concepts of managed care as they relate to the business aspects of medical practice. This updated guide relates the current mechanics of managed care and illustrates their application to medical practice management. Invaluable resources such as reviews of the fundamentals and concepts, terminology and definitions, a clarification of various roles of physicians in managed care, and tools for assessing plans and reviewing contracts are included. This book will keep you ahead of managed care trends and ensure that your practice remains fiscally solid while providing the highest quality care possible to patients.
Author : Wendy Knight
Publisher : Unknown
Page : 392 pages
File Size : 47,8 Mb
Release : 1997
Category : Managed care plans (Medical care)
ISBN : UCAL:B5019107
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.
Author : John F. McCally
Publisher : McGraw-Hill Health Care Education Group
Page : 196 pages
File Size : 55,7 Mb
Release : 1996
Category : Electronic
ISBN : 0786311495
Author : Scott Becker
Publisher : Unknown
Page : 420 pages
File Size : 40,8 Mb
Release : 1999
Category : Managed care plans (Medical care)
ISBN : UOM:39015043276297
Broad changes in the methods of paying for health care services have led to vast changes in the practice of medicine. This book provides the basic tools, including checklists, sample contracts, and key terms a physician needs to take charge of his or her future in the evolving health care system. It explains models and concepts that are available from market to market. More important, this book provides numerous tested strategies for responding to opportunities and the basic principles and means by which to judge situations and proposals. It will guide today's physicians through the managed care maze as they develop business plans and negotiate contracts. * Helps you take and maintain control over patient care by maximizing your autonomy. * Outlines differences in practice type and summarizes the pros and cons of your various options within the managed care environment. * Uses real-life examples throughout, discussing both successes and failures of other entrepreneurial physicians.
Author : Reed Tinsley
Publisher : American Medical Association Press
Page : 132 pages
File Size : 54,9 Mb
Release : 1999
Category : Medical
ISBN : PSU:000047285583
This book provides thorough guidance on how to successfully negotiate both discounted fee-for-service and capitated managed care contracts and offers strategies designed to improve managed care contracting relationships.
Author : Bruce S. Pyenson,Milliman & Robertson, Inc.
Publisher : Jossey-Bass
Page : 0 pages
File Size : 46,8 Mb
Release : 1998-04-29
Category : Medical
ISBN : 1556482132
Providers who ignore the fundamentals of risk management may be placing their organizations in peril. This book helps leaders of such organizations to develop systems that succeed in controlling managed care risk. Hospitals, physicians, integrated deliver systems (IDSs), and other providers that deliver care face unique challenges of risk that differ from those of most insurers and HMOs. Managing Risk addresses risk issues concerning these diverse provider groups and discusses: Quantifying risks of capitation and other managed care arrangements Using a funds flow model to spread risk How provider information systems (ISs) relate to an organization's ability to manage financial risk. Operational and clinical approaches to managing risk Financial incentive programs for physicians PSOs and the future of health care risk
Author : Maria K. Todd
Publisher : Irwin Professional Publishing
Page : 296 pages
File Size : 43,7 Mb
Release : 1996
Category : Business & Economics
ISBN : UOM:49015002584135
Today's managed care contract arrangements require that the provider understand the mechanics, legal aspects and market share implications of single signature, network-oriented, capitated and discounted fee-for-service payment arrangements. This work provides this information and shows the reader how to: evaluate both payer-proposed and self-authored managed care agreements; position their facility and services to secure and maintain managed care agreements that will yield oportunity for more patients and new business; negotiate a profitable managed care contract using suggested techniques for evaluating the capitation rates provided by prospective payers; and develop a capitation rate from their own data and data supplied by the payer.