The Physician's Guide to Managed Care PDF Download
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Author: David B. Nash
Publisher: Jones & Bartlett Learning
ISBN: 9780834203938
Category : Medical
Languages : en
Pages : 280
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Book Description
You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.
Author: David B. Nash
Publisher: Jones & Bartlett Learning
ISBN: 9780834203938
Category : Medical
Languages : en
Pages : 280
Get Book Here
Book Description
You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.
Author: Maria K. Todd
Publisher: CRC Press
ISBN: 1439866570
Category : Business & Economics
Languages : en
Pages : 334
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Book Description
Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don‘t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what contingencies to cover ... and when to ask a lawyer
Author: Peter R. Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 128415209X
Category : Medical
Languages : en
Pages : 355
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Book Description
Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.
Author: Peter Reid Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 9780763724962
Category : Medical
Languages : en
Pages : 918
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Book Description
Author: Peter Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 0763759112
Category : Education
Languages : en
Pages : 295
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Book Description
The origins of managed health care -- Types of managed care organizations and integrated health care delivery systems -- Network management and reimbursement -- Management of medical utilization and quality -- Internal operations -- Medicare and Medicaid -- Regulation and accreditation in managed care.
Author: Dennis Hursh
Publisher: Advantage Media Group
ISBN: 1599323133
Category : Business & Economics
Languages : en
Pages : 125
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Book Description
Get Your Career Off on the Right Track! Everything Physicians Need to Know About Employment Contracts COMPENSATION AND BENEFITS *Dangers of productivity compensation *Common incentive compensation formulas - what needs to be included *Benefits to look out for in addition to your compensation *How to determine if you are "disabled," and how the employer should NOTbe able to make this determination *What the employer can, and can't negotiate as far as benefits *Stark law traps, and how to avoid them RESTRICTIVE COVENANTS *What's really important in restrictive covenants, and what isn't worth negotiating over *Minimizing the impact of a restrictive covenant *How you can be released from a restrictive covenant *Negotiation strategies in buy-outs of restrictive covenants CALL COVERAGE *The language you must have DEFINING WHAT IS EXPECTED OF YOU *Patient contact hours expectations *What flexibility an employer will demand THE TERM OF THE AGREEMENT *Issues with hospital and managed care credentialing, and how to work around them *Grounds for termination *"Without cause" termination issues OTHER ISSUES IN AGREEMENTS TO WATCH OUT FOR *Medical record issues *Assignment of location of service *Budgetary weasel language to avoid *Malpractice issues in common provisions MALPRACTICE INSURANCE *The types of coverage, and the significance when you leave *Need for "tail coverage" *How to minimize the devastating cost of "tail coverage" PRIVATE PRACTICE ISSUES *Time to ownership *Concerns with "guaranteed" ownership *Costs of the buy-in *Methodologies for determining the buy-in, and the pros and cons of each *Why a cheap buy-in may not be in your best interest *What provisions are absolutely vital in regard to future ownership
Author: William A. Garofalo
Publisher: Jossey-Bass
ISBN: 9780787945817
Category : Health & Fitness
Languages : en
Pages : 0
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Book Description
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: David Dranove
Publisher: Princeton University Press
ISBN: 1400824680
Category : Medical
Languages : en
Pages : 220
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Book Description
The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions. The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients. Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.
Author: Douglas E. Hough
Publisher:
ISBN:
Category :
Languages : en
Pages : 24
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Book Description
Author: James R. Lyle
Publisher: Healthcare Consultants Incorporated
ISBN:
Category : Medical
Languages : en
Pages : 404
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Book Description
Discusses various types of managed care organizations including physician organizations (PO), physician-hospital organizations (PHO), preferred provider organizations (PPO), management services organizations (MSO), and health maintenance organizations (HMO).
