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Related Experiment Videos

Achieving incremental volume increases.

J E Belt1

  • 1Jennings Ryan & Kolb, Atlanta, GA, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|March 8, 1997
PubMed
Summary
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Managed care contracts can increase patient volume, but success requires specific contract provisions. Providers should negotiate terms like discounts and network limitations to ensure higher patient numbers.

Area of Science:

  • Health Services Research
  • Healthcare Management
  • Contract Negotiation

Background:

  • Managed care organizations (MCOs) aim to control healthcare costs and utilization.
  • Provider assumptions of increased patient volume from managed care contracts are not always met.
  • Effective contract negotiation is crucial for realizing mutual benefits.

Purpose of the Study:

  • To identify key contract provisions that enhance patient volume for healthcare providers.
  • To explore strategies for improving the success of managed care contracts.
  • To understand the factors influencing the provider-MCO relationship.

Main Methods:

  • Analysis of contract provisions within managed care agreements.
  • Review of factors influencing patient volume in provider networks.

Related Experiment Videos

  • Qualitative assessment of negotiation dynamics between providers and MCOs.

    • Main Results:

    • Specific contract clauses, including volume-based discounts and network restrictions, correlate with increased patient volume.
    • Patient financial incentives and provider directory accuracy are significant factors.
    • Successful negotiation leads to improved provider-MCO relationships and mutual understanding.

    Conclusions:

    • Providers can proactively influence patient volume by strategically negotiating managed care contract terms.
    • Collaboration on contract provisions fosters stronger, more successful partnerships between providers and MCOs.
    • Addressing contract details is essential for maximizing the benefits of managed care arrangements.