decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Risk Sharing / Service Costs, Personnel, Equipment Need to be Considered
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Article Overview
This article discusses the nonclinical considerations involved in managed care participation, especially the administrative costs tied to case management and the importance of evaluating financial and legal issues up front. It is aimed at practices and administrators assessing whether a managed care arrangement is worthwhile and sustainable. The guidance is broad and focuses on planning, cost awareness, and contract-related considerations rather than coding.
Why This Topic Matters
Understanding the full cost of participation can help practices avoid underestimating administrative workload and unexpected expenses when entering managed care arrangements.
What You Will Learn
- Why administrative costs matter in managed care participation
- What kinds of practice resources may be needed to support case management activities
- Why financial and legal review is important before joining a plan
- Why early evaluation of managed care relationships can reduce later problems
Who Should Read This
- Physician practices
- Practice managers
- Medical administrators
- Managed care participants
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