Clinicians hold the key to profitable managed care contracting.
A managed care contract's effect on the financial health of an organization is related in part to utilization and quality management issues. Physicians and other clinicians who are involved in case management can illuminate how these issues, in relation to the contract terms, can affect the organization's bottom line. Clinicians should be part of a contract-negotiating team that also includes financial professionals and contract negotiators, in addition to legal counsel.
Habibi
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Hospital for Joint Diseases Orthopaedic Institute, New York, New York, USA.
Finch
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D019090:Case Management; D003284:Contract Services / Q000191:economics / Q000458:organization & administration*; D005246:Feedback; D005376:Financial Management / Q000379:methods*; D007324:Institutional Management Teams; D008329:Managed Care Programs / Q000191:economics*; D017008:Negotiating; D010819:Physician's Role; D011907:Rate Setting and Review; D014481:United States; D014600:Utilization Review