The managed care contract: implementation in radiation oncology

Area of Science:

• Oncology
• Healthcare Management
• Nursing Practice

Background:

• Managed care capitation is an evolving model impacting healthcare delivery.
• Radiation oncology services are increasingly subject to managed care contracts.

Purpose of the Study:

• To evaluate the advantages and disadvantages of managed care capitation in radiation oncology.
• To define the essential roles of nurses within managed care contracts.

Main Methods:

• Literature review of published articles.
• Analysis of professional organization publications (American Nurse Association, American College of Radiology).
• Inclusion of newspaper articles, newsletters, and oral presentations.

Main Results:

• Fox Chase Cancer Center initiated one of the first capitated radiation oncology service agreements in 1992.
• Capitation offers potential benefits and drawbacks for both consumers and healthcare providers.
• Nurses' engagement with managed care principles can optimize patient and institutional outcomes.

Conclusions:

• Nurses require comprehensive knowledge of managed care to navigate its influence on patient care delivery.
• Understanding market forces is crucial for all nursing staff and management.
• Key nursing roles in managed care include educator, coordinator, negotiator, and patient advocate.