An integrated approach to managed care contracting.
Managed care plans make up an increasing share of today's hospital payer mix. As a result, it is important for hospitals to negotiate the best possible managed care contract terms in order to minimize risk and maximize opportunity. This article presents a six-step "closed loop" approach to managed care contracting, showing how hospitals can integrate--through their information systems--the strategic, financial, and patient care processes that are part of the managed care cycle.
Shapleigh
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Transition Systems, Inc., Boston, MA.
D000067:Accounts Payable and Receivable; D003211:Concurrent Review; D003284:Contract Services / Q000592:standards*; D005377:Financial Management, Hospital / Q000379:methods*; D007345:Insurance Claim Review; D008329:Managed Care Programs / Q000191:economics*; D017008:Negotiating; D010350:Patient Credit and Collection; D012308:Risk Management; D014481:United States; D014600:Utilization Review