Table of Contents

I. The Essentials of Managed Care and Capitation
1. Capitation
2. Reimbursement Systems and Managed Care
3. Referral Guidelines
4. Negotiating Managed Care Contracts
5. The Legal Issues of Managed Care Contracts
6. Understanding Profiling
7. Ethical Challenges of Managed Care
II. Utilizing Outcomes in a Managed Care Environment
8. Outcomes Research: Where We Have Been, Where We Need to Go
9. Meaningful Outcomes Research
10. Improving Health Care: Measuring Outcomes and Implementing Change
11. Project Solo/Physicians' Information Exchange: Organizing Physicians Around Quality
III. Quality in the Front and the Back Office
12. Improving Office Efficiency in a Managed Care Environment
13. Staffing Requirements in Managed Care
14. Surviving and Thriving as an Independent Practitioner: The Search for Continuous Quality Improvement
15. Information Management in Managed Care and Capitation
16. Malpractice Issues
IV. The Physician's Response to Managed Care
17. Network Mergers and IPAs: The Legal Issues
18. Physician Organizations
19. Single-Specialty Networks: The Mature Network
20. Single-Specialty Networks: Initial Stages
21. Mergers and Acquisitions
22. Evolving a Single Specialty Into a Multispecialty Network
23. Will Doctors Take Back Health Care?

About the Author

Otolaryngology/Head and Neck Surgery, Community Hospital, Indianapolis, IN, USA