A new physician's guide to evaluating managed care opportunities.
BACKGROUND
This article is designed for new physicians and administrators who evaluate and negotiate as providers with managed care organizations.


OBJECTIVE
To provide a review of the major issues impacting on medical practices as they develop contractual relationships with managed care organizations.


OBJECTIVE
1. To review the four major types of health maintenance organizations, providing some general detail about the financial policies of each. 2. To outline how utilization review and quality assurance policies can affect individual physician practice. 3. To discuss risk-sharing arrangements employed by managed care organizations, including their financial and clinical impact, and to outline the issues a new physician should consider when evaluating a contract.
Molloy
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Molloy & Co., Management & Planning Consultants, Manhassett, NY, USA.
D002204:Capitation Fee; D003284:Contract Services / Q000191:economics / Q000458:organization & administration / Q000592:standards; D003657:Decision Making; D004502:Education, Medical, Continuing; D006279:Health Maintenance Organizations / Q000145:classification / Q000191:economics / Q000458:organization & administration*; D008389:Marketing of Health Services; D017146:Models, Organizational; D016134:Organizational Policy; D011216:Practice Management, Medical; D011785:Quality Assurance, Health Care; D020414:Risk Sharing, Financial; D014481:United States; D014600:Utilization Review