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Related Experiment Videos

Rate structuring in managed care contracts demands detailed information.

G F Moran

    Medical Group Management Journal
    |June 7, 1993
    PubMed
    Summary

    Managed care contracts vary widely, with capitation and discounted fee-for-service as examples. Evaluating your management information system is crucial for successful contract negotiation in the evolving healthcare landscape.

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    Area of Science:

    • Healthcare Management
    • Health Economics

    Background:

    • Managed care is a dominant force in contemporary healthcare delivery.
    • Diverse contract models are emerging within managed care systems.

    Purpose of the Study:

    • To highlight the variability in managed care contract structures.
    • To emphasize the importance of robust management information systems for negotiation.

    Main Methods:

    • Analysis of prevailing managed care contract types.
    • Assessment of information system requirements for negotiation.

    Main Results:

    • Managed care contracts are not monolithic, encompassing various forms beyond capitation and discounted fee-for-service.
    • Inadequate data generation capabilities hinder effective contract negotiation.

    Conclusions:

    • Healthcare organizations must adapt to the dynamic nature of managed care.
    • Investment in and optimization of management information systems are essential for navigating managed care contracts effectively.

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