The Managed Care Contracting Handbook

The Managed Care Contracting Handbook PDF

Author: Maria K. Todd

Publisher: CRC Press

Published: 2009-03-26

Total Pages: 334

ISBN-13: 1439866570

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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

The Managed Care Contracting Handbook

The Managed Care Contracting Handbook PDF

Author: Maria K. Todd

Publisher: CRC Press

Published: 2009-03-26

Total Pages: 211

ISBN-13: 1040081118

DOWNLOAD EBOOK →

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

AHLA Health Plans Contracting Handbook (AHLA Members)

AHLA Health Plans Contracting Handbook (AHLA Members) PDF

Author: American Health Lawyers Association

Publisher:

Published: 2021

Total Pages:

ISBN-13: 9781663313874

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The Handbook traces the managed care contracting process from preparing to negotiate the contract, to formation and implementation, to termination issues.With contributions from more than twenty authors, the book includes nearly 300 sample clauses, many from the authors' own files. The clauses provide variations in language to illustrate potential advantages to the respective parties, as well as factors to consider when negotiating in today's dynamic legal and business context. This practical work also includes checklists, a health plan contracting term glossary, and a fully annotated provider agreement template.The latest trends and emerging issues.The authors have thoroughly updated each chapter and added new chapters to address emerging issues in managed care contracting, including:Managed care penetration into Medicare and MedicaidValue-based payments and the associated financial and operational considerationsLarge health systems launching as independent payers or through integrated delivery modelsThe rise of direct-to-employer contractingA growing need to address uses and ownership of dataIncreasing focus on considerations when a provider does not have a contract with a payerAnd more!

Managed Care Contracting

Managed Care Contracting PDF

Author: William A. Garofalo

Publisher: Jossey-Bass

Published: 1999-01-06

Total Pages: 0

ISBN-13: 9780787945817

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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

AHLA Health Plans Contracting Handbook (Non-Members)

AHLA Health Plans Contracting Handbook (Non-Members) PDF

Author: American Health Lawyers Association

Publisher:

Published: 2021

Total Pages:

ISBN-13: 9781663313898

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The Handbook traces the managed care contracting process from preparing to negotiate the contract, to formation and implementation, to termination issues.With contributions from more than twenty authors, the book includes nearly 300 sample clauses, many from the authors' own files. The clauses provide variations in language to illustrate potential advantages to the respective parties, as well as factors to consider when negotiating in today's dynamic legal and business context. This practical work also includes checklists, a health plan contracting term glossary, and a fully annotated provider agreement template.The latest trends and emerging issues.The authors have thoroughly updated each chapter and added new chapters to address emerging issues in managed care contracting, including:Managed care penetration into Medicare and MedicaidValue-based payments and the associated financial and operational considerationsLarge health systems launching as independent payers or through integrated delivery modelsThe rise of direct-to-employer contractingA growing need to address uses and ownership of dataIncreasing focus on considerations when a provider does not have a contract with a payerAnd more!

Managed Care Contracting

Managed Care Contracting PDF

Author: Wendy Knight

Publisher:

Published: 1997

Total Pages: 392

ISBN-13:

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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.