Which port in the storm? Can a contract management system alone meet all your managed care requirements?
Tina Morrison, L Dunbrack
Abstract
Tina Morrison, L Dunbrack
Abstract
For the past decade, contract management was synonymous with managed care for hospitals. Today, managed care is taking on new meaning, especially as hospital administrators and clinicians begin to think "outside the four walls." To address the increasing demands managed care is placing on hospitals, the vendors of contract management software are adding HMO-like functionality to their systems. The vendors claim their products can confirm eligibility, track referrals, process claims and even calculate capitation, in addition to managing contract administration. How do these enhanced contract management systems differ from managed care information systems used by managed care organizations to perform essentially the same functions?
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For the past decade, contract management was synonymous with managed care for hospitals. Today, managed care is taking on new meaning, especially as hospital administrators and clinicians begin to think "outside the four walls." To address the increasing demands managed care is placing on hospitals, the vendors of contract management software are adding HMO-like functionality to their systems. The vendors claim their products can confirm eligibility, track referrals, process claims and even calculate capitation, in addition to managing contract administration. How do these enhanced contract management systems differ from managed care information systems used by managed care organizations to perform essentially the same functions?
Key concepts: Managed care, Capitation, Business, Contract management, Utilization management, Operations management, Port (circuit theory), Health care