Biomaterial Database

Trends in managed care contracting. 1991

J Gallagher

This article describes trends in managed care contracting and offers physicians practical guidance for evaluating managed care plans and negotiating and dealing with problems in managed care contracts.

UI	MeSH Term	Description	Entries
D008318	Malpractice	Failure of a professional person, a physician or lawyer, to render proper services through reprehensible ignorance or negligence or through criminal intent, especially when injury or loss follows. (Random House Unabridged Dictionary, 2d ed)	Professional Negligence,Negligence,Negligence, Professional,Professional Negligences
D008329	Managed Care Programs	Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.	Case Management, Insurance,Insurance Case Management,Managed Health Care Insurance Plans,Managed Care,Care, Managed,Managed Care Program,Management, Insurance Case,Program, Managed Care,Programs, Managed Care
D010816	Physician Incentive Plans	Compensatory plans designed to motivate physicians in relation to patient referral, physician recruitment, and efficient use of the health facility.	Incentive Plans, Physician,Incentive Plan, Physician,Physician Incentive Plan,Plan, Physician Incentive,Plans, Physician Incentive
D003284	Contract Services	Outside services provided to an institution under a formal financial agreement.	Services, Contract,Contract Service,Service, Contract
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.
D016365	Liability, Legal	Accountability and responsibility to another, enforceable by civil or criminal sanctions.	Institutional Liability,Personal Liability,Professional Liability,Legal Liability,Medical Liability,Torts,Institutional Liabilities,Legal Liabilities,Liabilities, Institutional,Liabilities, Legal,Liabilities, Medical,Liabilities, Personal,Liabilities, Professional,Liability, Institutional,Liability, Medical,Liability, Personal,Liability, Professional,Medical Liabilities,Personal Liabilities,Professional Liabilities,Tort