The dominance of managed care is spreading quickly and risk managers are suddenly faced with major new challenges. With Managing the Risks of Managed Care, the risk manager will learn about risk management challenges in an integrated delivery system. The book also presents expert analysis on issues like contracting, peer review, ethical dilemmas, antitrust and more.

Providers who ignore the fundamentals of risk management may be placing their organizations in peril. This book helps leaders of such organizations to develop systems that succeed in controlling managed care risk. Hospitals, physicians, integrated deliver systems (IDSs), and other providers that deliver care face unique challenges of risk that differ from those of most insurers and HMOs. Managing Risk addresses risk issues concerning these diverse provider groups and discusses: Quantifying risks of capitation and other managed care arrangements Using a funds flow model to spread risk How provider information systems (ISs) relate to an organization's ability to manage financial risk. Operational and clinical approaches to managing risk Financial incentive programs for physicians PSOs and the future of health care risk

This thoroughly revised and updated book provides a strategic and operational resource for use in planning and decision-making. The Handbook enables readers to fine-tune operation strategies by providing updates on critical managed care issues, insights to the complex managed care environment, and methods to gain and maintain cost-efficient, high quality health services. With 30 new chapters, it includes advice from managers in the field on how to succeed in every aspect of managed care including: quality management, claims and benefits administration, and managing patient demand. The Handbook is considered to be the standard resource for the managed care industry.

Risk Management Handbook for Health Care Organizations, Student Edition This comprehensive textbook provides a complete introduction to risk management in health care. Risk Management Handbook, Student Edition, covers general risk management techniques; standards of health care risk management administration; federal, state and local laws; and methods for integrating patient safety and enterprise risk management into a comprehensive risk management program. The Student Edition is applicable to all health care settings including acute care hospital to hospice, and long term care. Written for students and those new to the topic, each chapter highlights key points and learning objectives, lists key terms, and offers questions for discussion. An instructor's supplement with cases and other material is also available. American Society for Healthcare Risk Management (ASHRM) is a personal membership group of the American Hospital Association with more than 5,000 members representing health care, insurance, law, and other related professions. ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking, and interactions with leading health care organizations and government agencies. ASHRM initiatives focus on developing and implementing safe and effective patient care practices, preserving financial resources, and maintaining safe working environments.

Now is the time to make sure managed care doesn't manage you. This resource provides an overview of today's concepts of managed care as they relate to the business aspects of medical practice. This updated guide relates the current mechanics of managed care and illustrates their application to medical practice management. Invaluable resources such as reviews of the fundamentals and concepts, terminology and definitions, a clarification of various roles of physicians in managed care, and tools for assessing plans and reviewing contracts are included. This book will keep you ahead of managed care trends and ensure that your practice remains fiscally solid while providing the highest quality care possible to patients.