Document Detail


Evaluating and negotiating a profitable capitation contract.
MedLine Citation:
PMID:  10164876     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Evaluating the financial terms of capitation contracts and negotiating their nonfinancial provisions are becoming increasingly important responsibilities for healthcare financial managers. To evaluate the financial terms of a contract, financial managers must understand both incremental and replacement pricing strategies. They also must understand when strategic positioning objectives make a capitated plan attractive despite limited financial rewards. Before a contract is accepted, financial managers can take steps to increase its potential profitability by negotiating the nonfinancial provisions that can help control contract expenses. These provisions are related to services to be provided, payment terms, withholds and risk pools, access to data, provision of eligibility data, utilization review and quality assurance procedures, filing of grievances, contract renewal terms, and contract termination.
Authors:
K M Kennedy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Healthcare financial management : journal of the Healthcare Financial Management Association     Volume:  51     ISSN:  0735-0732     ISO Abbreviation:  Healthc Financ Manage     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-03-26     Completed Date:  1997-03-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8215859     Medline TA:  Healthc Financ Manage     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  44-9     Citation Subset:  H    
Affiliation:
ECG Management Consultants, Seattle, WA, USA.
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MeSH Terms
Descriptor/Qualifier:
Capitation Fee / standards*
Contract Services / economics
Decision Making, Organizational
Evaluation Studies as Topic
Fee-for-Service Plans / economics
Financial Management, Hospital / methods*
Managed Care Programs / economics*
Models, Organizational
Negotiating*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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