title: Cutting out the middleman: physicians can contract directly with employers--a viable alternative to adversarial managed care agreements.
abstract: HMOs, PPOs, and other managed care "middlemen" control the means by which most physicians do business with employers. As physicians face dwindling reimbursements, greater practice restrictions, and increased pressure to sign adversarial middleman contracts, interest in direct contracting has grown. This article introduces direct contracting as an important alternative to commercial managed care agreements; cites the key advantages and process of direct contracting; and offers practical recommendations for helping physician practices successfully negotiate direct physician/employer agreements.
authors.affiliation: A.J. Lester & Associates, Inc., 9898 Bissonnet Avenue, Suite 678, Houston, TX 77036, USA. ajlester@directmanagedcare.com
authors.forename: Howard
authors.initials: H
authors.lastname: Lester
mesh_terms: D003284:Contract Services / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D017598:Efficiency, Organizational; D005245:Fee Schedules; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008329:Managed Care Programs / Q000191:economics; D017008:Negotiating; D011216:Practice Management, Medical / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D017009:Professional Autonomy; D014481:United States