ABSTRACT
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 hav
TABLE OF CONTENTS
section Section I|2 pages
Introduction to Provider Organizations
chapter 1|8 pages
The Goals and Objectives of Physician Alignment and Integration
Form Follows Function
section Section II|2 pages
Integrated Health Delivery System Development
chapter 7|10 pages
The Steering Committee Gets Busy
Step-by-Step Instructions for What to Do and How to Do It
chapter 9|6 pages
Network Financial Management
The Intersection of Finance, Utilization Management and Capitated Risk Management
chapter Chapter 12|20 pages
Antitrust Compliance Task Force
Understanding Antitrust Concerns for Provider Networks
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section Section III|2 pages
Business Development
chapter 20|10 pages
Beyond Traditional HMO and PPO Contracts
Direct Contracting with Employer-Sponsored Health Benefit ERISA Plans