Download or read book The Managed Care Contracting Handbook written by Maria K. Todd and published by CRC Press. This book was released on 2009-03-26 with total page 334 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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
Download or read book Managed Care Contracting written by Wendy Knight and published by . This book was released on 1997 with total page 392 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Managed Care Contracting written by William A. Garofalo and published by Jossey-Bass. This book was released on 1999-01-06 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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
Download or read book Resource Guide and Work Book for MCH CSHCN Providers written by and published by . This book was released on 1997 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Contracting With Managed Care Organizations written by Joseph A. Welfeld and published by . This book was released on 1996-05-01 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Contracting with Managed Care Organizations written by Joseph A. Welfeld, FACHE and published by Jossey-Bass. This book was released on 1996-05-29 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: From preparing for the shift to a managed care environment to negotiating the terms of managed care agreements, this executive briefing offers guidance for evaluating and negotiating with managed care organizations (MCOs) to create important strategic relationships--and details the steps necessary to execute a strategic approach to managed care contracting. The author describes the key performance indicators for evaluating an MCO and offers valuable insight into an MCO's contracting requirements and provider network strategy. Also outlined are the essential operational and functional components in managed care agreements and ways for the health care provider to control or limit risk. Additionally, Contracting with Managed Care Organizations provides a unique clause-by-clause comparison between an undesirable and a desirable hospital agreement with an MCO.
Download or read book Improving the Medicare Market written by Institute of Medicine and published by National Academies Press. This book was released on 1996-11-01 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.
Download or read book Managed Care and Capitation Contracting for Home Health Agencies written by Ann W. Ino and published by . This book was released on 1996 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive manual will guide home health executives through the maze of capitation/at-risk contracting, the development of operational systems, etc. Contracting strategies, writing proposals, financial issues, and quality management are covered. Sample contracts, agreements, proposals, and spreadsheets will further enhance the manual's usefulness.
Download or read book The Managed Care Contracting Handbook written by Maria K. Todd and published by CRC Press. This book was released on 2009-03-26 with total page 211 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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
Download or read book An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies written by Sara Rosenbaum and published by . This book was released on 1997 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Top Managed Care Contracting Clauses written by Peter Robert Fisk and published by HC Pro, Inc.. This book was released on 2007 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a provider, your survival hinges on your ability to maximize reimbursements from managed care contracts and control access to agreed-upon discounts. But money lost at the time of service or through the collection process is often determined well before the patient ever comes through the door. In many cases, that money was lost back when the contract was negotiated. Top Managed Care Contracting Clauses: A Toolkit for Providers contains practical strategies and tools for any organization facing the prospect of negotiating a new managed care contract.
Download or read book Contracting for Managed Substance Abuse and Mental Health Services written by Stephen Moss and published by DIANE Publishing. This book was released on 2000-09 with total page 318 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, State Medicaid agencies and other public sector entities -- in particular, State, county, and local substance abuse and mental health (SA&MH) authorities -- have increasingly been taking the initiative to purchase SA&MH managed care (MC) services from private sector org's. or specialized nonprofit agencies. This is a practical guide for public purchasers and others involved in the design and develop. of MC initiatives involving SA&MH services. Chapters: designing, procuring, and implementing a MC system; coverage; contracting for network services; the mgmt. info. system; quality mgmt.; financial issues; and consumer protections. Bibliography.
Download or read book An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies and Between State Medicaid Agencies and Managed Care Organizations written by Sara Rosenbaum and published by DIANE Publishing. This book was released on 1998-12 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: A descriptive examination of: (1) the structure & content of provider network agreements between managed care organizations (MCOs) & community mental health & substance abuse (MH/SA) treatment & prevention agencies, proving an assessment of provider contracts to identify the meaning of these instruments for MH/SA service providers, group purchasers, MCOs, individual consumers, & public policy makers; & 2) service agreements between State Medicaid agencies & MCOs for mental health & substance abuse treatment services, addressing enrollment, benefits & services, duties, & quality assurance.
Download or read book Negotiating Managed Care Contracts written by Medical Management Institute and published by McGraw-Hill Companies. This book was released on 1994 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Contracting for Public Mental Health Services written by Terry Savela and published by DIANE Publishing. This book was released on 2008-06 with total page 33 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report synthesizes the collective experiences of four managed behavioral health care organizations (MBHOs) that hold public sector managed care carve-out contracts. Four representatives of these MBHOs participated in a day-long focus group meeting, and two others were interviewed by telephone. Contents: Approach to the Study; Program Design; Financial Requirements and Reimbursement; Procurement Process; Implementation and Ongoing Administration; Recommendations of Focus Group Participants; Summary References; and Appendix: List of Focus Group Participants.
Download or read book Managed Care Contracting written by Douglas A. Conrad and published by . This book was released on 1996 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: However, successful managed care contracting is a daunting challenge, requiring a range of skills from creating an organizational vision and strategy to pricing specific services. Managed Care Contracting provides all the necessary tools to meet the challenge of managed care contracting.
Download or read book Physician s Managed Care Success Manual written by Scott Becker and published by . This book was released on 1999 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
