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Author: Maurice J. Penner
Publisher: Maurice Penner
ISBN: 9781567930511
Category : Capitation fees (Medical care)
Languages : en
Pages : 298
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Book Description
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: Maurice J. Penner
Publisher: Maurice Penner
ISBN: 9781567930511
Category : Capitation fees (Medical care)
Languages : en
Pages : 298
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Book Description
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: Lawrence Casalino
Publisher:
ISBN:
Category : Capitation fees (Medical care)
Languages : en
Pages : 66
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Book Description
Author: Penner
Publisher:
ISBN:
Category :
Languages : de
Pages :
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Book Description
Author: Janice Ney
Publisher:
ISBN:
Category : Health maintenance organizations
Languages : en
Pages : 78
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Book Description
Author: David I. Samuels
Publisher: Irwin Professional Publishing
ISBN:
Category : Business & Economics
Languages : en
Pages : 184
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Book Description
Capitation is defined as "a type of risk sharing reimbursement method whereby providers in a plan's network receive fixed periodic payments for health services rendered to plan members". This definition doesn't necessarily mean that hospitals need to lose money. This book provides the tools and techniques for minimizing the financial risk that is associated with this process while maintaining the bottom line.
Author: Lawrence Peter Casalino
Publisher:
ISBN:
Category : Group medical practice
Languages : en
Pages : 804
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Book Description
Author: Eve A. Kerr
Publisher:
ISBN:
Category : Capitation fees (Medical care)
Languages : en
Pages : 5
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Book Description
All physician groups reported using gatekeeping and preauthorization for certain referrals or tests. Most also used profiling of utilization patterns (79%), guidelines (70%), and managed care education (69%). Most physician groups asked gatekeepers to submit preauthorization requests for specialty referrals and restricted patient self-referral. For example, 60% of groups required preauthorization for an internal medicine subspecialty referral, and 7% allowed patient self-referral. Most groups also asked gatekeepers to obtain preauthoirzation for many tests (for example, 95% for magnetic resonance imaging and 53% for pulmonary function tests). Preauthorization requests were denied infrequently (less than 10% of the time) by more than 75% of groups. Of the 54 groups reporting utilization profiles to their physicians, 61% never adjusted for case-mix among patients and more than 60% suggested practice changes to their physicians based on utilization. Fewer than 35% of the groups used written guidelines for expensive tests that required preauthorization (such as angiography).
Author: California. Department of Health Services
Publisher:
ISBN:
Category : Community health services for older people
Languages : en
Pages : 70
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Book Description
Author: Sandra Hunt
Publisher: California Healthcare Foundation
ISBN: 9781929008131
Category : Managed care plans (Medical care)
Languages : en
Pages : 31
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Book Description
Author: California. Department of Health Services
Publisher:
ISBN:
Category : Health maintenance organizations
Languages : en
Pages : 54
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Book Description
