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Rating managed care plans as business partners.
Healthc Financ Manage. 1997 Mar; 51(3):41-2, 44.HF

Abstract

Managed care plans are driven to meet consumer quality of care demands. But, plans that meet these consumer demands do not necessarily meet provider expectations for quality business partnerships. Therefore, providers need to develop not only clinical performance indicators but also indicators that will help them evaluate managed care plans as business partners. Performance indicators should be developed to measure managed care plans' medical loss ratio, compensation cost/benefit, payment promptness, authorization convenience and promptness, insurance verification convenience and promptness, payment accuracy, medical management, provider relations responsiveness, member education effectiveness, recorded complaints, risk transfer, contract terms, and contract equity.

Authors+Show Affiliations

Barber RL
Carolinas Hospital network, Charlotte, NC, USA.

MeSH

Capitation FeeContract ServicesCost-Benefit AnalysisFinancial AuditInservice TrainingManaged Care ProgramsNegotiatingOrganizational AffiliationQuality of Health CareReimbursement MechanismsRisk ManagementUnited States

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10165437

Citation

Barber, R L.. "Rating Managed Care Plans as Business Partners." Healthcare Financial Management : Journal of the Healthcare Financial Management Association, vol. 51, no. 3, 1997, pp. 41-2, 44.
Barber RL. Rating managed care plans as business partners. Healthc Financ Manage. 1997;51(3):41-2, 44.
Barber, R. L. (1997). Rating managed care plans as business partners. Healthcare Financial Management : Journal of the Healthcare Financial Management Association, 51(3), 41-2, 44.
Barber RL. Rating Managed Care Plans as Business Partners. Healthc Financ Manage. 1997;51(3):41-2, 44. PubMed PMID: 10165437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rating managed care plans as business partners. A1 - Barber,R L, PY - 1997/2/6/pubmed PY - 1997/2/6/medline PY - 1997/2/6/entrez SP - 41-2, 44 JF - Healthcare financial management : journal of the Healthcare Financial Management Association JO - Healthc Financ Manage VL - 51 IS - 3 N2 - Managed care plans are driven to meet consumer quality of care demands. But, plans that meet these consumer demands do not necessarily meet provider expectations for quality business partnerships. Therefore, providers need to develop not only clinical performance indicators but also indicators that will help them evaluate managed care plans as business partners. Performance indicators should be developed to measure managed care plans' medical loss ratio, compensation cost/benefit, payment promptness, authorization convenience and promptness, insurance verification convenience and promptness, payment accuracy, medical management, provider relations responsiveness, member education effectiveness, recorded complaints, risk transfer, contract terms, and contract equity. SN - 0735-0732 UR - https://www.unboundmedicine.com/medline/citation/10165437/Rating_managed_care_plans_as_business_partners_ L2 - https://medlineplus.gov/managedcare.html DB - PRIME DP - Unbound Medicine ER -