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Related Experiment Videos

Medicare+Choice PSO formation: a step-by-step decision process.

S B Clay1

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

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|February 6, 1998
PubMed
Summary

Healthcare providers can now contract directly with Medicare via provider-sponsored organizations (PSOs) under Medicare + Choice. A methodical seven-step process guides providers through assessing, forming, and applying for these substantial opportunities.

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Area of Science:

  • Healthcare Management
  • Health Policy
  • Public Health

Background:

  • Medicare + Choice program introduction creates new contracting avenues for healthcare providers.
  • Provider-Sponsored Organizations (PSOs) enable direct contracting with Medicare.
  • Significant time, resources, and risks are associated with establishing and managing PSOs.

Purpose of the Study:

  • To outline a structured approach for healthcare providers.
  • To guide providers in evaluating and pursuing Medicare + Choice PSO opportunities.
  • To facilitate the process from initial assessment to contract application.

Main Methods:

  • A systematic seven-step process is proposed.
  • The process covers assessment, planning, and application phases.

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  • Methodology focuses on mitigating risks and optimizing resource allocation.

    • Main Results:

    • A clear pathway is defined for providers interested in PSOs.
    • The seven-step process provides a roadmap for successful PSO formation.
    • Providers can navigate the complexities of Medicare + Choice contracting more effectively.

    Conclusions:

    • Healthcare providers should adopt a methodical approach to Medicare + Choice PSO opportunities.
    • The proposed seven-step process offers a practical framework for engagement.
    • Strategic planning is crucial for providers to leverage direct Medicare contracting effectively.