A guide to evaluating managed care companies.
Managed care has gradually been replacing the traditional way in which doctors and patients interact. These changes are taking place at an increasing pace, which strongly suggests there will be a dramatic trend to managed care programs. It has become imperative to understand the business of medicine beyond the traditional "business manager" tasks of setting fees, analyzing tax consequences, and balancing the check book. Providers may be hard pressed to maintain the quality of care they feel comfortable giving as the regulations of managed care exert their pressures. A rational, systematic approach to evaluate managed care firms is presented in this article. Additional criteria will have to be added as new ideas for managed care evolve. Physicians and practices must make decisions concerning the level of their participation, depending on a variety of factors, some more sensible than others.
Health Care Cost Consulting Group, Mequon, WI.
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D003284:Contract Services / Q000191:economics / Q000592:standards*; D003659:Decision Making, Organizational; D005069:Evaluation Studies as Topic; D005245:Fee Schedules; D005375:Financial Audit / Q000379:methods; D008329:Managed Care Programs / Q000191:economics / Q000592:standards*; D008330:Management Audit / Q000379:methods; D010934:Planning Techniques; D012051:Reimbursement Mechanisms; D014481:United States