Guidelines for physician contracting with alternative delivery systems.
The rapid proliferation of alternative healthcare delivery systems--particularly health maintenance organizations (HMOs) and preferred provider organizations (PPOs)--means that physicians contemplating participation in one of these entities must obtain, at the least, information about the group's ability to operate efficiently and effectively. For physicians who are contracting directly with a specific HMO, PPO, or independent practice association (IPA), issues that are relevant in all situations include termination, submission of data, discipline procedures, no solicitation covenants, arbitration clauses, rights to discontinue treatment, use of consultants, compliance with state and federal laws, and exclusivity.
D003284:Contract Services / Q000331:legislation & jurisprudence*; D005376:Financial Management / Q000331:legislation & jurisprudence*; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006801:Humans; D007348:Insurance, Health / Q000458:organization & administration*; D010820:Physicians; D011243:Preferred Provider Organizations / Q000458:organization & administration*; D014481:United States; D014600:Utilization Review