Medicare+Choice plans. Medicare risk contracting opportunities for provider-sponsored organizations.
New federal legislation approves provider sponsored networks as direct contractors with Medicare. To date, financial, licensure and requirements differ, but providers should prepare to enter the new market. Niche physician groups, physician-hospital organizations and physician-HMO alliances are all configurations that should meet federal requirements.
Miller
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Miller & Holguin, Los Angeles, CA 90067, USA.
D000368:Aged; D002204:Capitation Fee; D014487:Centers for Medicare and Medicaid Services, U.S.; D019058:Community Networks / Q000191:economics / Q000458:organization & administration*; D003284:Contract Services / Q000191:economics / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D017047:Cost Sharing / Q000331:legislation & jurisprudence; D006279:Health Maintenance Organizations / Q000191:economics / Q000458:organization & administration; D006759:Hospital-Physician Joint Ventures / Q000191:economics / Q000458:organization & administration; D006801:Humans; D007193:Independent Practice Associations / Q000191:economics / Q000458:organization & administration; D019458:Insurance Coverage; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D006278:Medicare / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010067:Ownership; D012308:Risk Management / Q000191:economics / Q000331:legislation & jurisprudence; D014481:United States