Ulteriori informazioni
Practicing physicians in the 1990s are under intense pressure from all sides. Large insurers threaten clinical autonomy while increasing professional risk; complex contracts demand new levels of business expertise; and a skeptical public questions skills and honesty more than ever before.
This timely new book is the first to offer real solutions to these problems from the perspective of the working physician. Edited by Dr. Steven Isenberg, and featuring contributions from experts in law and business as well as clinical medicine, MANAGED CARE, OUTCOMES, AND QUALITY gives the physician or administrator the help he or she needs to ensure top-quality care in the 1990's and beyond.
Sommario
I. The Essentials of Managed Care and Capitation
1. Capitation
2. Reimbursement Systems and Managed Care
3. Referral Guidelines
4. Negotiating Managed Care Contracts
5. The Legal Issues of Managed Care Contracts
6. Understanding Profiling
7. Ethical Challenges of Managed Care
II. Utilizing Outcomes in a Managed Care Environment
8. Outcomes Research: Where We Have Been, Where We Need to Go
9. Meaningful Outcomes Research
10. Improving Health Care: Measuring Outcomes and Implementing Change
11. Project Solo/Physicians' Information Exchange: Organizing Physicians Around Quality
III. Quality in the Front and the Back Office
12. Improving Office Efficiency in a Managed Care Environment
13. Staffing Requirements in Managed Care
14. Surviving and Thriving as an Independent Practitioner: The Search for Continuous Quality Improvement
15. Information Management in Managed Care and Capitation
16. Malpractice Issues
IV. The Physician's Response to Managed Care
17. Network Mergers and IPAs: The Legal Issues
18. Physician Organizations
19. Single-Specialty Networks: The Mature Network
20. Single-Specialty Networks: Initial Stages
21. Mergers and Acquisitions
22. Evolving a Single Specialty Into a Multispecialty Network
23. Will Doctors Take Back Health Care?
Riassunto
Practicing physicians in the 1990s are under intense pressure from all sides. Large insurers threaten clinical autonomy while increasing professional risk; complex contracts demand new levels of business expertise; and a skeptical public questions skills and honesty more than ever before.
This timely new book is the first to offer real solutions to these problems from the perspective of the working physician. Edited by Dr. Steven Isenberg, and featuring contributions from experts in law and business as well as clinical medicine, MANAGED CARE, OUTCOMES, AND QUALITY gives the physician or administrator the help he or she needs to ensure top-quality care in the 1990's and beyond.
