{"title":"The antitrust risks of management services organizations, medical foundations, and integrated delivery systems.","authors":"J T Rosch, H Tada","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This chapter focuses on the antitrust implications of forming a fully integrated delivery system. The danger lies in a challenge by the federal government or private parties, if the proposed system threatens the development of competing systems or excludes individuals or entities. By explaining the risks facing less integrated arrangements involving medical foundations and management services organizations, why forming an integrated system may resolve some of those risks, and the advantages and disadvantages of other options, this chapter also points out one of the primary benefits of forming an integrated system: reducing the antitrust risks. Finally, general suggestions are posed to minimize the antitrust risks when planning and developing any collaborative effort among providers.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 3","pages":"37-45"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19181184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Shared leadership in health care organizations.","authors":"M D Merry","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This chapter explores why the leaders of both the medical profession and provider organizations are often in conflict, and why they must ultimately come together to create new leadership models for future health care organizations. Modern management concepts of knowledge/learning organizations, total quality process, and reengineering call for an innovative form of shared, truly collaborative leadership between clinicians and \"scientific\" managers.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 4","pages":"26-38"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18969892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hospital-physician relations: the recruitment perspective.","authors":"S A Cejka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One of the biggest problems in the health care industry today is the supply and demand of physicians. As health care organizations scramble to recruit physicians for vital positions, they find themselves in a highly competitive and exhausting battle. As the health care industry changes, so do the needs and desires of physicians, especially young physicians. The heart and soul of a good recruitment program must include understanding who physicians are and what motivates them, selecting the right candidate, and most importantly, retaining them once you have gone to the time, expense, and heartache of recruiting them. Understanding how integrated systems can deal with these factors in the most effective and efficient way is key to surviving and thriving in an era of health care reform.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 4","pages":"55-62"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18969115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Replacing the workshop model.","authors":"R H Rosenfield","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The U.S. health care delivery system is undergoing precipitate reorganization. The focus of medical care is shifting to group practice, away from the work of individuals. This chapter surveys this reorganization, presenting a review of the system beforehand, examining hospital-affiliated group practices, and posing questions about the impact the emerging system may have on physician-hospital relationships.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 4","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18969890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Financing of integrated delivery systems.","authors":"E Pierce","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This chapter addresses the financing of integrated delivery systems. It discusses the assessment of financing needs and taxable financing options, including standard commercial loans, lines of credit, commercial paper, and taxable bonds. The chapter also addresses tax-exempt financing, including tax-exempt bonds, and eligibility for tax-exempt financing.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 3","pages":"28-36"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19181183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Special Medicare reimbursement and fraud and abuse considerations for management services organizations, medical foundations, and integrated delivery systems.","authors":"P R DeMuro, J F Owens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This chapter discusses certain Medicare reimbursement and fraud and abuse considerations for management services organizations (MSOs), medical foundations, and integrated delivery systems. It stresses the necessity of a business plan, the sources of capitalization that might be used in creating an integrated delivery system, and their effect on Medicare reimbursement. It also discusses related party principles and considerations and the Medicare \"incident to\" regulations. Furthermore, it discusses the application of certain Medicare safe harbor regulations on MSOs' structures and services, and those of medical foundations and integrated delivery systems.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 3","pages":"54-60"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19181186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Miscellaneous legal issues affecting integrated delivery systems, foundations, and management services organizations.","authors":"J F Owens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This chapter addresses some of those legal issues that uniquely affect the formation or operations of an integrated delivery system (IDS), a foundation, or a management services organization (MSO), but which are not discussed in any other chapters. This chapter gives special insight and guidance on issues such as licensing, credentialing and peer review, employee benefit plans, prohibitions against physician self-referrals, and the rules on disclosure of ownership and control.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 3","pages":"61-9"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19181187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Organizational and business issues affecting integrated delivery systems.","authors":"G R Peters","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This chapter discusses the nature of an integrated system, the reasons for developing an integrated delivery system, and various organizational structures that might be used. The chapter then identifies several of the critical business issues affecting the development of an integrated system.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 3","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19181180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case study: the integration of a medical foundation and an independent practice association.","authors":"R A Waterman, M L Bonham","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This chapter is a case study of a nonprofit medical foundation and an independent practice association. It discusses the different cultures and statutory, governance, and other issues, including the development of the bylaws and managed care agreement.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 3","pages":"80-5"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19181189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrating management of physician groups and hospitals.","authors":"A S MacDonald","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This chapter discusses the management challenges facing hospitals as they enter into formal organizational and economic linkages with physician organizations. Managing physician organizations does not simply mean controlling physicians through employment arrangements, but rather providing an organizational structure through which physicians can work together and with the hospital toward a common goal of creating a high-quality, cost-effective system of patient care. Integration of the management approaches required to run hospitals and physician groups successfully represents a significant challenge. Meeting this challenge is key to creating an organization that will be able to truly manage care.</p>","PeriodicalId":76749,"journal":{"name":"Topics in health care financing","volume":"20 4","pages":"48-54"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18969894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}