ABSTRACT
With the proportion of patient care activity controlled by managed care organizations skyrocketing, providers need to study managed care trends, understand their strategic implications, and devise a response to them. Tremendous opportunities exist for hospitals that offer their own managed care programs, as long as they can avoid making costly mistakes. A critical tool is an overall strategy that includes collaboration with physicians, internal organization to manage risk, and direct contracting.
Subject(s)
Financial Management, Hospital/trends , Managed Care Programs/organization & administration , Contract Services , Decision Making, Organizational , Evaluation Studies as Topic , Feasibility Studies , Managed Care Programs/economics , Managed Care Programs/statistics & numerical data , United States , Utilization Review/economicsABSTRACT
Creating a successful PHO is a delicate process that requires a great deal of finesse, experience, and collaboration.
Subject(s)
Hospital-Physician Joint Ventures/organization & administration , Managed Care Programs/organization & administration , Contract Services/economics , Contract Services/organization & administration , Cost-Benefit Analysis , Economic Competition , Group Practice/economics , Group Practice/organization & administration , Hospital-Physician Joint Ventures/economics , Interprofessional Relations , Managed Care Programs/economics , Models, Theoretical , Organizational Objectives , Planning Techniques , United StatesABSTRACT
Direct contracting offers an aggressive approach to health care cost containment in an era when employers, patients and providers must do more than just talk about saving dollars. Eliminating the "middleman" through customized insurance plans, direct contracts can combat rising costs. The author explains what hospitals must do to initiate a program.
