Building and Managing Effective Physician Organizations Under CapitationJones & Bartlett Learning, 1996 - 363 pages This resource offers you a unique Building Block system, a proven-effective tool used by organizations to survive and prosper in an era of different reimbursement schemes, from discounted fee-for-service and primary care capitation, to global capitation and percent of premium payment. |
Contents
Chapter 1Building Effective Physician Equity Alliances | 3 |
Profiling Management Services Organizations as a Central | 25 |
Todays Market Competition Demands Action and Merger | 31 |
Chapter 3Strategies for Communicating with Physicians in the Era | 58 |
The Five Stages of Managed Care and Physician Organizations | 72 |
Chapter 5Using Advanced Physician Management Structure To Ensure Clinical | 87 |
Chapter 6Expansion Process for Physician Organizations | 103 |
Getting Started | 128 |
Chapter 13Managed Care Contracting and Reimbursement for Physician | 231 |
Reimbursement Methodologies for Managed Care | 241 |
Risk Sharing | 248 |
Understanding the MCO Contract | 263 |
Conclusion | 276 |
Chapter 15Critical Issues in Negotiating Capitated Contracts | 278 |
Negotiating the Rate | 286 |
Preparing the Organization for Capitation Negotiations | 293 |
Stories from the Front Lines | 134 |
When Is Change Appropriate? | 140 |
Physicians Take Leadership | 149 |
Strategic Alliance Decisions | 159 |
Chapter 10Selecting Information Systems for Managing MSOS | 191 |
Planning the Information Systems | 206 |
Managing Change | 213 |
Outcomes DataWhat Are They? | 219 |
Future Trends | 225 |
Conclusion | 300 |
Chapter 16Developing and Operating PhysicianDriven HMOs | 309 |
Miscellaneous | 316 |
Understanding the Capitation Contract | 323 |
The Bottom LineWhat Specialists Should Expect from Their | 331 |
Winning through Adaptation | 337 |
Chapter 19Creating the Future through Todays Vision and Actions | 348 |
| 353 | |
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Common terms and phrases
agement agreement ambulatory antitrust assets capitation contract capitation rate cians clinical communication compensation plan corporation cost enrollees entity fee-for-service goals group practice health care health care delivery health system Healthcare hospital implementation Independent Practice Associations information systems investment investors issues joint venture managed care contracting managed health plans management company Management Services Management Services Organization measures medi Medicaid medical group medical management medical practices Medicare MedPartners ment merger merging multispecialty needs negotiating operations organizational outcomes ownership parties patient satisfaction payer payment percent physi Physician Equity Alliance physician group physician leaders Physician Organizations PPMC practice management primary care physicians professional profits programs provider purchasers referrals regional relationship requires revenue risk share shareholders sicians specialists specialty network Stark law strategy structure tice tient tion utilization zation