Managed care, outcomes, and quality: a practical guide
Practicing physicians in the 1990s are under intense pressure from all sides. Large insurers threaten clinical autonomy while increasing professional risk; complex contracts demand new levels of business expertise; and a skeptical public questions skills and honesty more than ever before. This timely new book is the first to offer real solutions to these problems from the perspective of the working physician. Edited by Dr. Steven Isenberg, and featuring contributions from experts in law and business as well as clinical medicine, MANAGED CARE, OUTCOMES, AND QUALITY gives the physician or administrator the help he or she needs to ensure top-quality care in the 1990's and beyond.
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The Legal Issues of Managed Care Contracts
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adenoidectomy analysis antitrust assessment BATNA benchmarking benefits capitated contracts capitation rate cians claims Clinical Improvement Clinical Value Compass committee comorbidity consultants copayment cost Dartmouth-Hitchcock Medical Center delivery disease-specific effective employers ethical evaluation fee-for-service flowchart functional status group practice guidelines health plan health status healthcare hospital identified important individual initial issues liability managed care contract managed care plans measures medical practice Medicare ment merger multispecialty Neck negotiation organization otitis media otolaryngology outcomes research outcomes study parties patient satisfaction payers payment PCPs physi physician network population primary problem procedure providers referral reimbursement relationship require responsible risk schedule single-specialty specialists specialty specialty networks specific staff surgery surgical survey tient tion tonsillectomy treatment tympanostomy tubes utilization utilization review vendors visits Worksheet