Managed Care Contracting Handbook: Planning and Negotiating the Managed Care Relationship (Hfma Healthcare Financial Management Series)

Today's managed care contract arrangements require that the provider understand the mechanics, legal aspects and market share implications of single signature, network-oriented, capitated and discounted fee-for-service payment arrangements. This work provides this information and shows the reader how to: evaluate both payer-proposed and self-authored managed care agreements; position their facility and services to secure and maintain managed care agreements that will yield oportunity for more patients and new business; negotiate a profitable managed care contract using suggested techniques for evaluating the capitation rates provided by prospective payers; and develop a capitation rate from their own data and data supplied by the payer.