The managed care contracting handbook : planning and negotiating the managed care relationship

Today's managed care contract arrangements require that the provider understand the mechanics, legal aspects and market share implications of single signature, network-oriented, capitated and discounted fee-for-service payment arrangements. This work provides this information and shows the reader how to: evaluate both payer-proposed and self-authored managed care agreements; position their facility and services to secure and maintain managed care agreements that will yield oportunity for more patients and new business; negotiate a profitable managed care contract using suggested techniques for evaluating the capitation rates provided by prospective payers; and develop a capitation rate from their own data and data supplied by the payer.