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