You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.

This book answers the growing need for concise, practical information about the business aspects of medicine. Written for medical students, residents, and physicians interested in medical management, it covers issues such as the forces shaping health care delivery, physician management skills, economic aspects of managed care, medical, scientific and legal considerations in health care delivery and business aspects of medical management. With a focus on the skills and theory behind medical management, rather than on specifics, this book is a must-have primer for medical trainees and professionals.

Options for physicians working within the prepaid medicine system make sense when you understand the pros and cons, strategies, and structures analyzed in this guide to the new managed care environment. -- Evolution of the managed care movement -- Myths about organizational requirements for managed care success -- Pros and cons of solo practice versus IPA, PHO, or group practice -- Working for a hospital or HMO -- Entrepreneurial, legal, and regulatory characteristics of each model -- Best opportunities for primary care and specialist physicians -- The ideal physician organization for managed care -- Future winners and losers, quality of care, reform, and Wall Street Analyze the cost and benefits of practice and managed care proposals, because an informed choice makes good medicine work.

Provides physicians, administrators, and other health professionals with information on managed care, from its history, forms and practices to detailed information on managed care contracting, physician compensation, monitoring, reporting, management, risk, productivity, and accountability. Annotati

Get Your Career Off on the Right Track! Everything Physicians Need to Know About Employment Contracts COMPENSATION AND BENEFITS *Dangers of productivity compensation *Common incentive compensation formulas - what needs to be included *Benefits to look out for in addition to your compensation *How to determine if you are "disabled," and how the employer should NOTbe able to make this determination *What the employer can, and can't negotiate as far as benefits *Stark law traps, and how to avoid them RESTRICTIVE COVENANTS *What's really important in restrictive covenants, and what isn't worth negotiating over *Minimizing the impact of a restrictive covenant *How you can be released from a restrictive covenant *Negotiation strategies in buy-outs of restrictive covenants CALL COVERAGE *The language you must have DEFINING WHAT IS EXPECTED OF YOU *Patient contact hours expectations *What flexibility an employer will demand THE TERM OF THE AGREEMENT *Issues with hospital and managed care credentialing, and how to work around them *Grounds for termination *"Without cause" termination issues OTHER ISSUES IN AGREEMENTS TO WATCH OUT FOR *Medical record issues *Assignment of location of service *Budgetary weasel language to avoid *Malpractice issues in common provisions MALPRACTICE INSURANCE *The types of coverage, and the significance when you leave *Need for "tail coverage" *How to minimize the devastating cost of "tail coverage" PRIVATE PRACTICE ISSUES *Time to ownership *Concerns with "guaranteed" ownership *Costs of the buy-in *Methodologies for determining the buy-in, and the pros and cons of each *Why a cheap buy-in may not be in your best interest *What provisions are absolutely vital in regard to future ownership

This book is a guide to strategic training for physicians in an era of managed care. The first half of the book provides a step-by-step process to help physicians take their practices into the new world of integrated delivery systems. The second half of the book covers a variety of key topics such as credentialing, reimbursement systems, and utilization management.