Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Managed care contracting for specialists.

J M Alexander1

  • 1Brown, Rudrick, Freed & Gesmer, Boston, MA, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|May 29, 1999
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Local adaptation at range edges: comparing elevation and latitudinal gradients.

Journal of evolutionary biology·2015
Same author

Nuclear architecture as an epigenetic regulator of neural development and function.

Neuroscience·2014
Same author

Widespread phenotypic and genetic divergence along altitudinal gradients in animals.

Journal of evolutionary biology·2013
Same author

Energy loss for heavy quarks in relation to light partons: is radiative energy loss for heavy quarks anomalous?

Physical review letters·2009
Same author

Has the QCD critical point been signaled by observations at the BNL relativistic heavy ion collider?

Physical review letters·2007
Same author

Bioactive N-terminal undecapeptides derived from parathyroid hormone: the role of alpha-helicity.

The journal of peptide research : official journal of the American Peptide Society·2005
Same journal

Highlights from the HFM blog.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

Hospitals face challenges from Medicare cost and payment trends.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

The fate of value-based care with an ACA repeal.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

Beyond the Medicare annual well visit: maximizing revenue for hospital-owned practices.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

Incorporating social determinants into population health management.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

Health Care 2020 Part 3: Consolidation.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
See all related articles

Specialty managed care contracting involves understanding referral sources, costs, and payer needs. Specialists must evaluate payment models like resource-based relative value scale to negotiate optimal agreements.

Area of Science:

  • Healthcare Administration
  • Health Economics
  • Managed Care Contracting

Background:

  • Specialty physicians face increasing demands within managed care environments.
  • Understanding managed care contracting is crucial for financial viability and quality of care.
  • Carve-out and subcapitation agreements require specific financial and operational knowledge.

Purpose of the Study:

  • To elucidate the essential components of specialty managed care contracting.
  • To analyze different payment calculation methods for specialists in managed care.
  • To guide specialists in negotiating effective managed care contracts.

Main Methods:

  • Review of managed care contracting principles.
  • Analysis of three common payment calculation methods: resource-based relative value scale (RBRVS), per-referral basis, and point systems.

Related Experiment Videos

  • Discussion of provider considerations in contract negotiation.

    • Main Results:

    • Specialists must possess knowledge of referral sources, cost structures, and payer requirements.
    • Three distinct payment calculation methods (RBRVS, per-referral, point system) offer different financial outcomes.
    • Understanding these methods is key to successful negotiation.

    Conclusions:

    • Effective specialty managed care contracting necessitates a thorough understanding of financial models and market dynamics.
    • Specialists need to assess their practice's costs and referral patterns to select appropriate payment structures.
    • Informed negotiation leads to better contract terms for providers within managed care systems.