Health plans contracting handbook : a guide for payers and providers / by Robin Fisk, editor in chief ; Christina Degraff-Murphy, editor, Gregory R. Mitchell, editor.
Contributor(s): Fisk, Robin J [editor.] | American Health Law Association [issuing body.].
Material type:
TextPublisher: Washington, DC : American Health Law Association, [2021]Edition: Eighth edition.Description: xxxiii, 524 pages ; 28 cm.Content type: text Media type: unmediated Carrier type: volumeSubject(s): Managed care plans (Medical care) -- United States -- Handbooks, manuals, etc | Medical care -- Contracting out -- United States -- Handbooks, manuals, etc | Letting of contracts -- United States -- Handbooks, manuals, etc | Health insurance -- United States -- Handbooks, manuals, etcLOC classification: KF1183 | .H44 2021Summary: The Handbook traces the managed care contracting process from preparing to negotiate the contract, to formation and implementation, to termination issues. With contributions from more than twenty authors, the book includes nearly 300 sample clauses, many from the authors' own files. The clauses provide variations in language to illustrate potential advantages to the respective parties, as well as factors to consider when negotiating in today's dynamic legal and business context. This practical work also includes checklists, a health plan contracting term glossary, and a fully annotated provider agreement template. The latest trends and emerging issues. The authors have thoroughly updated each chapter and added new chapters to address emerging issues in managed care contracting, including: managed care penetration into Medicare and Medicaid, value-based payments and the associated financial and operational considerations, large health systems launching as independent payers or through integrated delivery models, the rise of direct-to-employer contracting, a growing need to address uses and ownership of data, increasing focus on considerations when a provider does not have a contract with a payer, and more!
| Item type | Current library | Shelving location | Call number | Status | Date due | Barcode | |
|---|---|---|---|---|---|---|---|
| Treatises and Periodicals | Hennepin County Law Library | Treatises | KF1183 .H44 2021 (Browse shelf(Opens below)) | Available | 35032002532788 |
Includes bibliographical references and index.
The Handbook traces the managed care contracting process from preparing to negotiate the contract, to formation and implementation, to termination issues. With contributions from more than twenty authors, the book includes nearly 300 sample clauses, many from the authors' own files. The clauses provide variations in language to illustrate potential advantages to the respective parties, as well as factors to consider when negotiating in today's dynamic legal and business context. This practical work also includes checklists, a health plan contracting term glossary, and a fully annotated provider agreement template. The latest trends and emerging issues. The authors have thoroughly updated each chapter and added new chapters to address emerging issues in managed care contracting, including: managed care penetration into Medicare and Medicaid, value-based payments and the associated financial and operational considerations, large health systems launching as independent payers or through integrated delivery models, the rise of direct-to-employer contracting, a growing need to address uses and ownership of data, increasing focus on considerations when a provider does not have a contract with a payer, and more!