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Structuring networks for maximum performance under managed care.

T R Miller

    Healthcare Financial Management : Journal of the Healthcare Financial Management Association
    |November 3, 1996
    PubMed
    Summary
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    Healthcare providers forming delivery networks must choose between noncorporate and corporate models. Corporate models offer better enforcement of provider behavior for overall network benefit.

    Area of Science:

    • Healthcare Management
    • Health Services Research
    • Network Organization

    Background:

    • Healthcare providers seek to establish delivery networks for managed care contracts.
    • Two primary network structures exist: noncorporate and corporate models.
    • Network structure impacts operational efficiency and contract success.

    Purpose of the Study:

    • To compare the noncorporate and corporate delivery network models.
    • To identify the advantages of each network structure for healthcare providers.
    • To determine which model best supports network-wide provider behavior.

    Main Methods:

    • Comparative analysis of noncorporate and corporate delivery network structures.
    • Review of governance and management infrastructure in each model.

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  • Evaluation of the ability to enforce provider behavior.

    • Main Results:

    • Noncorporate models feature a single governing body for contracting and business.
    • Corporate models possess unified governance managing all network business.
    • Corporate models demonstrate superior enforcement of provider behavior aligned with network interests.

    Conclusions:

    • Both noncorporate and corporate models can be effective.
    • Corporate delivery networks are generally more effective at enforcing provider behavior.
    • Choosing the right structure is crucial for successful managed care contracting.