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Related Experiment Videos

Maximizing revenues in managed care contracting.

J Brice

    The Healthcare Forum Journal
    |August 7, 1989
    PubMed
    Summary

    Hospitals can maximize revenue from managed care contracts by implementing product innovations that ensure adherence to pre-admission procedures and utilize automated tools for billing and receivables management. This strategy also aids in negotiating profitable contracts by providing timely financial data.

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    Area of Science:

    • Healthcare Administration
    • Health Economics
    • Health Information Technology

    Background:

    • Hospitals face increasing pressure to maximize revenue within the managed care contracting environment.
    • Payment and contract negotiation success are directly linked to operational efficiency and financial transparency.

    Purpose of the Study:

    • To examine how product innovations can address hospitals' needs in managed care contracting.
    • To identify key factors influencing successful revenue maximization and contract negotiation.

    Main Methods:

    • Analysis of the current contracting environment and its impact on hospital operations.
    • Identification of essential components for successful managed care contracting.

    Main Results:

    • Adherence to contractual terms in pre-admission procedures is crucial for guaranteed payment.
    • Automated tools for billing proration and receivables management enhance full payment likelihood.
    • Timely financial information empowers negotiators to secure profitable Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) contracts.

    Conclusions:

    • Product innovations should focus on streamlining pre-admission processes and automating financial management.
    • Equipping hospital negotiators with real-time financial data is vital for successful contract.

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