Managed Care Contracting

Managed Care Contracting

Author: William A. Garofalo

Publisher: Jossey-Bass

Published: 1999-01-06

Total Pages: 0

ISBN-13: 9780787945817

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Today's heath care marketplace is highly competitive, requiring managed care providers to contract with dozens of insurers to survive. Each of these contracts comes with their its unique terms and conditions-making the contracting process overwhelmingly complex and giving many health care executives major headaches. Written by three of the country's leading health care consultants and attorneys, Managed Care Contracting is the first book to offer executives with no legal background practical, step-by-step advice on how to create winning contracts between health care organizations, payers, and employers. In straightforward language, free of legalese and jargon, this much-needed resource demystifies managed care contracting and prescribes some critical advice for hospital and physician group practice executives. The authors present helpful guidelines for evaluating the various types of managed care contracts and explain the most significant terms and concepts executives are likely to encounter. A treasure trove of information for health care executives no matter what their experience level, Managed Care Contracting Examines how to develop a contracting strategy Reviews the fundamentals of negotiating the contract Frames the key steps in the contracting process Provides a managed care contract negotiations checklist Dissects sample hospital and physician contracts Analyzes the contract risk factors by the type of payment explores the implications of changing financial incentives Outlines the most up-to-date information in the regulatory environment Includes illustrative examples and helpful tables and chartsFor health care executives who are just beginning the complex contracting process and for the more experienced who require the most current information on the topic, Managed Care Contracting provides the knowledge and tools they need to succeed. "Managed Care Contracting is a very timely


The Final Hurdle

The Final Hurdle

Author: Dennis Hursh

Publisher: Advantage Media Group

Published: 2012-05-15

Total Pages: 125

ISBN-13: 1599323133

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Get Your Career Off on the Right Track! Everything Physicians Need to Know About Employment Contracts COMPENSATION AND BENEFITS *Dangers of productivity compensation *Common incentive compensation formulas - what needs to be included *Benefits to look out for in addition to your compensation *How to determine if you are "disabled," and how the employer should NOTbe able to make this determination *What the employer can, and can't negotiate as far as benefits *Stark law traps, and how to avoid them RESTRICTIVE COVENANTS *What's really important in restrictive covenants, and what isn't worth negotiating over *Minimizing the impact of a restrictive covenant *How you can be released from a restrictive covenant *Negotiation strategies in buy-outs of restrictive covenants CALL COVERAGE *The language you must have DEFINING WHAT IS EXPECTED OF YOU *Patient contact hours expectations *What flexibility an employer will demand THE TERM OF THE AGREEMENT *Issues with hospital and managed care credentialing, and how to work around them *Grounds for termination *"Without cause" termination issues OTHER ISSUES IN AGREEMENTS TO WATCH OUT FOR *Medical record issues *Assignment of location of service *Budgetary weasel language to avoid *Malpractice issues in common provisions MALPRACTICE INSURANCE *The types of coverage, and the significance when you leave *Need for "tail coverage" *How to minimize the devastating cost of "tail coverage" PRIVATE PRACTICE ISSUES *Time to ownership *Concerns with "guaranteed" ownership *Costs of the buy-in *Methodologies for determining the buy-in, and the pros and cons of each *Why a cheap buy-in may not be in your best interest *What provisions are absolutely vital in regard to future ownership


Understanding and Negotiating Construction Contracts

Understanding and Negotiating Construction Contracts

Author: Kit Werremeyer

Publisher: John Wiley & Sons

Published: 2023-07-19

Total Pages: 390

ISBN-13: 1394150202

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Understanding and Negotiating Construction Contracts The complexities of construction contracts are made easy with this thorough and readable guide Construction contracts can be complex for both owners and contractors. For contractors, negotiating fair and balanced commercial terms in contracts is just as important as properly managing projects; a properly negotiated contract can mitigate unnecessary risk and unnecessary risk transfer. This, in turn, reduces exposure to financial liability for the contractor and for avoidance of contract claims and disputes. Understanding and Negotiating Construction Contracts provides a comprehensive and readable introduction to the world of construction contracts. Providing, for example, coverage of the four most common types of contracts—lump sum/fixed-price, cost-plus, time-and-materials, and unit-pricing—it promises to reduce uncertainty and allow contractors to enter contractual negotiations with greater confidence to be able to achieve a fair and balanced contract. This updated new edition reflects the up-to-date best practices to understand how to better negotiate the commercial terms and conditions in construction contracts. Readers of the second edition of Understanding and Negotiating Construction Contracts will also find: Updated information on indemnity, insurance, and negotiation An all-new chapter with a contract analysis checklist Real-world examples drawn from small residential, retail, large commercial, and international projects Understanding and Negotiating Construction Contracts is essential for construction professionals and college students studying construction contracts and the liabilities arising out of them.


Understanding and Negotiating Book Publication Contracts

Understanding and Negotiating Book Publication Contracts

Author: Brianna Schofield

Publisher:

Published: 2018

Total Pages: 280

ISBN-13:

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"Copyright law and contract language are complex, even for attorneys and experts. Authors may be tempted to sign the first version of a publication contract that they receive, especially if negotiating seems complicated, intimidating, or risky. But there is a lot at stake for authors in a book deal, and it is well worth the effort to read the contract, understand its contents, and negotiate for favorable terms. To that end, Understanding and Negotiating Book Publication Contracts identifies clauses that frequently appear in publishing contracts, explains in plain language what these terms (and typical variations) mean, and presents strategies for negotiating "author-friendly" versions of these clauses. When authors have more information about copyright and publication options for their works, they are better able to make and keep their works available in the ways they want"--Publisher.


Improving the Medicare Market

Improving the Medicare Market

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1996-11-01

Total Pages: 384

ISBN-13: 0309175364

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Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.


A Guide to Managed Care Medicine

A Guide to Managed Care Medicine

Author: William N. Tindall

Publisher: Jones & Bartlett Learning

Published: 2000

Total Pages: 322

ISBN-13: 9780834217652

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Provides physicians, administrators, and other health professionals with information on managed care, from its history, forms and practices to detailed information on managed care contracting, physician compensation, monitoring, reporting, management, risk, productivity, and accountability. Annotati


Getting to Yes

Getting to Yes

Author: Roger Fisher

Publisher: Houghton Mifflin Harcourt

Published: 1991

Total Pages: 242

ISBN-13: 9780395631249

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Describes a method of negotiation that isolates problems, focuses on interests, creates new options, and uses objective criteria to help two parties reach an agreement.


The Primary Care Provider's Guide to Compensation and Quality

The Primary Care Provider's Guide to Compensation and Quality

Author: Carolyn Buppert

Publisher: Jones & Bartlett Learning

Published: 2005

Total Pages: 472

ISBN-13: 9780763729585

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This book links quality and reimbursement issues, using a systems approach that clinicians may incorporate into their practice. Updated to provide practical advice for primary care providers (PCPs) about major trends that have emerged over the past five years, such as growing patient enrollment in managed care health plans, performance evaluation of PCPs by outside agencies, and the dramatic increase in billing being audited.Includes a free CD-ROM with customizable forms and checklists.


The Professor Is In

The Professor Is In

Author: Karen Kelsky

Publisher: Crown

Published: 2015-08-04

Total Pages: 450

ISBN-13: 0553419420

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The definitive career guide for grad students, adjuncts, post-docs and anyone else eager to get tenure or turn their Ph.D. into their ideal job Each year tens of thousands of students will, after years of hard work and enormous amounts of money, earn their Ph.D. And each year only a small percentage of them will land a job that justifies and rewards their investment. For every comfortably tenured professor or well-paid former academic, there are countless underpaid and overworked adjuncts, and many more who simply give up in frustration. Those who do make it share an important asset that separates them from the pack: they have a plan. They understand exactly what they need to do to set themselves up for success. They know what really moves the needle in academic job searches, how to avoid the all-too-common mistakes that sink so many of their peers, and how to decide when to point their Ph.D. toward other, non-academic options. Karen Kelsky has made it her mission to help readers join the select few who get the most out of their Ph.D. As a former tenured professor and department head who oversaw numerous academic job searches, she knows from experience exactly what gets an academic applicant a job. And as the creator of the popular and widely respected advice site The Professor is In, she has helped countless Ph.D.’s turn themselves into stronger applicants and land their dream careers. Now, for the first time ever, Karen has poured all her best advice into a single handy guide that addresses the most important issues facing any Ph.D., including: -When, where, and what to publish -Writing a foolproof grant application -Cultivating references and crafting the perfect CV -Acing the job talk and campus interview -Avoiding the adjunct trap -Making the leap to nonacademic work, when the time is right The Professor Is In addresses all of these issues, and many more.