Contracting with Managed Care Organizations
From preparing for the shift to a managed care environment to negotiating the terms of managed care agreements, this executive briefing offers guidance for evaluating and negotiating with managed care organizations (MCOs) to create important strategic relationships--and details the steps necessary to execute a strategic approach to managed care contracting. The author describes the key performance indicators for evaluating an MCO and offers valuable insight into an MCO's contracting requirements and provider network strategy. Also outlined are the essential operational and functional components in managed care agreements and ways for the health care provider to control or limit risk. Additionally, Contracting with Managed Care Organizations provides a unique clause-by-clause comparison between an undesirable and a desirable hospital agreement with an MCO.