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Related Experiment Videos

How to avoid being dropped from managed care plans

C W Bailey

    Postgraduate Medicine
    |May 15, 1994
    PubMed
    Summary
    This summary is machine-generated.

    Doctors are increasingly being terminated without cause by managed care plans, disrupting practices and patient care. This article provides guidance for physicians to mitigate the risk of such arbitrary contract terminations.

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    Area of Science:

    • Medical Practice Management
    • Healthcare Policy
    • Legal Aspects of Medicine

    Background:

    • Physician termination from managed care plans without cause is a growing concern in the U.S.
    • These terminations can lead to significant financial hardship for medical practices.
    • Established doctor-patient relationships are severed with minimal advance notice.

    Purpose of the Study:

    • To explore the phenomenon of unexplained physician termination from managed care organizations.
    • To offer practical strategies for physicians to reduce their vulnerability to arbitrary contract termination.
    • To provide insights from a plastic surgeon who is also an attorney on risk mitigation.

    Main Methods:

    • Review of current trends in managed care contract terminations.

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  • Analysis of the financial and relational impacts on medical practices.
  • Expert opinion and practical advice from a dual-qualified professional (physician and attorney).

    • Main Results:

    • Unexplained terminations pose a substantial financial and operational risk to physicians.
    • Proactive measures can potentially minimize the likelihood of contract termination without cause.
    • Understanding contractual terms and maintaining strong practice management are crucial.

    Conclusions:

    • Physicians should be aware of the increasing risk of arbitrary termination by managed care plans.
    • Implementing preventative strategies can help safeguard medical practices and patient continuity.
    • Seeking legal and professional guidance is advisable for navigating managed care contracts.