| Capitated contracting in radiology: negotiating techniques, financial calculations, and utilization management. | |
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MedLine Citation:
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PMID: 8628849 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The authors describe how to develop and manage a capitated outpatient radiology contract. Aspects of a capitated fee structure and the need to apportion fees between a hospital and its radiology group are discussed. During negotiations with a managed care organization (MCO), certain information and commitments should be obtained. Utilization data should also be obtained from the MCO, but if they are not available (or are thought to be unreliable), certain norms can be used. Once a utilization projection is arrived at, reimbursement calculations can be made and compared with assumed reimbursements under a known fee schedule, such as that of Medicare. This procedure allows one to estimate whether a capitated proposal is financially feasible. Once a contractual agreement is instituted, the radiology group must then track and manage utilization. An understanding of these principles should enable radiologists to deal effectively with both practice and fiscal concerns presented by managed care. |
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Authors:
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D C Levin; G H McArdle; C D Lockard |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Radiology Volume: 198 ISSN: 0033-8419 ISO Abbreviation: Radiology Publication Date: 1996 Mar |
Date Detail:
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Created Date: 1996-06-21 Completed Date: 1996-06-21 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0401260 Medline TA: Radiology Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 651-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Capitation Fee* Child Contract Services / economics*, organization & administration Humans Managed Care Programs / economics*, organization & administration Negotiating Outpatients / classification Radiography / utilization Radiology / economics*, statistics & numerical data Reimbursement Mechanisms Risk Management |
| Comments/Corrections | |
Comment In:
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Radiology. 1996 Aug;200(2):582-3
[PMID:
8685363
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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