Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what contingencies to cover ... and when to ask a lawyer for help.

• Decode and analyze reimbursement problems, loopholes, and contract stipulations you are likely to encounter
• Learn tried-and-true tricks, tools, shortcuts, and techniques to evaluate agreements
• Negotiate contracts that won t leave you open to unanticipated expenses

Written by Maria K. Todd, a seasoned professional in managed care contracting, this handbook is written for managers, analysts, and finance officers who have the daunting task of negotiating contracts for medical services. It offers an in-depth examination of managed care and its organizations and covers key areas, such as pay-for-performance initiatives, reimbursement methods, contract law basics, and negotiating strategies.

The Managed Care Contracting Handbook offers critical details and strategic information as well as resources on everything from HMOs and PPOs to Consumer Driven Health Plans (CDHP), self-funded ERSIA payers, and Medicaid managed care.

Fully updates the first edition, which was used widely in the U.S. and overseas.

Designed to equip you with the confidence that comes with knowing the right questions to ask and more answers than you are supposed to know, this easy-access resource

This handbook prepares readers to build the medical tourism service line, integrate physicians and other service providers, develop a safe and effective quality and patient-centered infrastructure, document processes and workflows, evaluate reimbursement contracts, and measure outcomes.

In concierge medicine, physicians develop amenities-rich membership programs and collect a monthly or annual membership fee to pay for the amenities in addition to the medical services rendered. Handbook of Concierge Medical Practice Design examines the many considerations physicians must make prior to transitioning their practices into concierge services. Maria K. Todd, a recognized expert in concierge medicine, branding, consulting, healthcare, marketing, medical tourism, planning, and physician practice administration, explains how to set up a concierge practice. She describes how this new business model affects workflow and outlines financial considerations including managed care payer relations, the hybrid practice, and predictive modeling to uncover the hidden factors that affect bottom-line performance. The book supplies readers with models for creating a business plan and a strategy for transforming a practice into a concierge practice. It concludes by covering the legal aspects of creating a concierge practice. It includes patient acquisition and retention strategies as well as detailed plans for adding additional doctors and physician extenders, such as nurse practitioners and physician assistants.The book provides sample employment contracts and advice on how to select and work with consultants. It includes chapters on business process re-engineering, workflow management, financial considerations, competitive analysis, developing a business plan, and how to market the new practice.

High Value Manufacturing is the result of the 6th International Conference on Advanced Research in Virtual
and Rapid Prototyping, held in Leiria, Portugal, October 2013. It contains current contributions to the fi eld
of virtual and rapid prototyping (V&RP) and is also focused on promoting better links between industry and
academia. This volume comprises a collection of more than 110 reviewed papers which cover a wide range of
topics, such as Additive and Nano Manufacturing Technologies, Biomanufacturing, Materials, Rapid Tooling
and Manufacturing, CAD and 3D Data Acquisition Technologies, Simulation and Virtual Environments, and
novel applications.

High Value Manufacturing is intended for engineers, designers and manufacturers who are active in the fi elds
of mechanical, industrial and biomedical engineering.

In addition to coordinating health travel logistics and gathering medical records, medical tourism facilitators play the role of travel agent, appointment setter, concierge, hotel reservationist, tour operator, and hand-holder to clients seeking health services domestically and abroad. Addressing the issues that are likely to emerge as clients travel, the Medical Tourism Facilitator's Handbook is a must-have resource of hard-to-find tools, checklists, terminology, and other helpful information for hospital-based, lay facilitators, travel agents, and even retired physicians and nurses. Supplying the advice of a recognized expert in global healthcare, the book provides a detailed and empathic understanding of patient needs and expectations. It covers the full range of best and worst case scenarios that can occur when clients travel to obtain health services. Using a conversational tone, it includes coverage of international travel logistics, where to find answers to immigration concerns, confidentiality/privacy issues, and unanticipated care in transit in the event of complications or missed connections. The book delivers a fast-moving presentation of useful information and teaches readers how to decode the language, what to look for in terms of safety and quality, how to decode hospital facilitator agent agreements, and how to anticipate clients' needs and expectations. It also includes access to a regularly updated website with helpful worksheets and reference material so you will be prepared to handle any scenario that might present itself when your clients travel.

In concierge medicine, physicians develop amenities-rich membership programs and collect a monthly or annual membership fee to pay for the amenities in addition to the medical services rendered. Handbook of Concierge Medical Practice Design examines the many considerations physicians must make prior to transitioning their practices into concierge services. Maria K. Todd, a recognized expert in concierge medicine, branding, consulting, healthcare, marketing, medical tourism, planning, and physician practice administration, explains how to set up a concierge practice. She describes how this new business model affects workflow and outlines financial considerations-including managed care payer relations, the hybrid practice, and predictive modeling-to uncover the hidden factors that affect bottom-line performance. The book supplies readers with models for creating a business plan and a strategy for transforming a practice into a concierge practice. It concludes by covering the legal aspects of creating a concierge practice. It includes patient acquisition and retention strategies as well as detailed plans for adding additional doctors and physician extenders, such as nurse practitioners and physician assistants. The book provides sample employment contracts and advice on how to select and work with consultants. It includes chapters on business process re-engineering, workflow management, financial considerations, competitive analysis, developing a business plan, and how to market the new practice.

"This revised and updated edition provides an invaluable resource for physicians who are looking to sell their practice and for health systems who wish to become affiliated with a group practice or who are interested in contracting with physicians. The book provides sample physician employment contracts and explains how each contract works. Written by an expert in the field of physician contracting, the text discusses the various legal and compliance issues related to physician employment, such as anti-self referral and anti-kickback issues, and examines how to resolve disputes through arbitration or mediation. The author also outlines the pros and cons of various partnership arrangements"--Provided by publisher.

Today, with physician and hospital reimbursement being cut and tied to quality incentives, physicians and health plans are revisiting the concept of integration. Payers are demanding that the industry do more with less without sacrificing quality of care. As a result, physicians again find themselves integrating and aligning with hospitals that have the resources they lack or must develop together. Written by an acknowledged expert in the field of physician integration and managed care contracting, Physician Integration & Alignment: IPA, PHO, ACOs, and Beyond examines physician integration and alignment in the current healthcare market. It outlines the common characteristics of integrated groups and various organizational structures, and also explains how you can avoid making the same mistakes of the past. Filled with suggestions and ideas from successfully integrated practices, the book: Identifies industry drivers for the resurgence of integrated models and the need for aligned models Provides a look at the common characteristics of integrated and aligned groups and how the components can work together Discusses antitrust and other regulatory concerns present when considering the right organizational and management structure Offers time- and money-saving checklists, lessons learned, models, and templates-saving you thousands of dollars in consulting fees Maria K. Todd provides readers with the vision and practical tools needed to organize their business entities in a manner that will maximize economic clout and provide quality of care for both the hospital and physician group. This much-needed resource includes helpful insights on topics such as declining physician reimbursement, declining margins, physician shortages, physician-hospital competition, rising practice investment requirements, the return to capitation as a payment mechanism, and recent changes in the relationships between physicians and health systems. Maria currently is the principle of the largest globally integrated health delivery system in the world with over 6,000 hospitals and 85,000 physicians spanning 95 countries. She has developed more than 200 integrated and aligned IPAs, PHOs, ACOs, MSOs and healthcare clusters in her career.