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Public sector contracting report : the monthly guide to Medicare and Medicaid managed care最新文献

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Troubled PHO reveals Medicare risk contracting strategy. 陷入困境的PHO揭示了医疗保险风险收缩策略。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-10-01
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引用次数: 0
Collect data, monitor claims receipts to ensure prompt Medicare, Medicaid payment. 收集数据，监控索赔收据，以确保及时支付医疗保险，医疗补助。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-10-01
{"title":"Collect data, monitor claims receipts to ensure prompt Medicare, Medicaid payment.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>What to do when your Medicare or Medicaid plan pays claims late. Doctors in New Mexico say they're going broke because health plans don't pay for months. But managed care plans with commercial lives aren't the only plans that pay claims late. Plans with Medicare and Medicaid lives also can have payment problems. Find out how the physicians in New Mexico are tackling the problem, and see what you can do to prevent it from happening to you.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 10","pages":"154-6"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21516492","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}
引用次数: 0
Model for PCP contracts offers right incentives for Medicare, Medicaid providers. PCP合同模式为医疗保险和医疗补助提供者提供了正确的激励。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-10-01
{"title":"Model for PCP contracts offers right incentives for Medicare, Medicaid providers.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Consider this model for PCP contracting. Provider organizations in Medicare and Medicaid often structure arrangements with their primary care providers that set up the organizations--and the doctors--to fail. An actuary from Milliman & Robertson in Seattle illustrates how to establish the right kinds of incentives for PCPs.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 10","pages":"149-53"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21516491","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}
引用次数: 0
CA study finds some challenges in Medicaid may be universal. 一项研究发现，医疗补助计划中的一些挑战可能是普遍存在的。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-10-01
{"title":"CA study finds some challenges in Medicaid may be universal.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Data File: Some Medicaid managed care challenges and trends appear universal. A baseline study of the county-organized health system and two-plan managed Medicaid models in California reveals the unique models haven't escaped some of the problems and trends faced by more traditional managed Medicaid plans and providers across the country.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 10","pages":"158-60"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21516370","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}
引用次数: 0
Reach out to community to develop culturally sensitive patient care. 与社区接触，发展具有文化敏感性的病人护理。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-10-01
{"title":"Reach out to community to develop culturally sensitive patient care.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Are you meeting the needs of your minority Medicaid members? Cultural competency is becoming an issue in managed Medicaid as minority populations grow, and states require plans to meet the needs of non-English-speaking members. But researchers find that plans don't offer much help to providers. Get some expert advice on how you can better meet the needs of a multicultural population.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 10","pages":"156-8"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21516369","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}
引用次数: 0
Medicaid expansion boosts membership, but watch for pent-up demand for services. 医疗补助计划的扩大扩大了会员人数，但要注意被压抑的服务需求。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-09-01
{"title":"Medicaid expansion boosts membership, but watch for pent-up demand for services.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Community health center-owned plan reshapes itself to tackle expanding Medicaid population, but providers suffer growing pains. To rescue its ailing plan and boost enrollment, Neighborhood Health Plan of Rhode Island pursued the uninsured and the Children's Health Insurance Program (CHIP). Learn how the provider plan changed its image and added 5,000 members, and what challenges its owner health centers still face. And in a related story, find out why CHIP rapidly is becoming a potentially attractive market for Medicaid providers.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 9","pages":"137-40"},"PeriodicalIF":0.0,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21478255","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}
引用次数: 0
Survey finds twofold variation in Medicaid payment rates. 调查发现医疗补助支付率存在双重差异。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-09-01
{"title":"Survey finds twofold variation in Medicaid payment rates.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 9","pages":"141-2"},"PeriodicalIF":0.0,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21478256","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}
引用次数: 0
Reverse caps in Medicare encourage primary care, better align incentives. 医疗保险的反向上限鼓励初级保健，更好地调整激励措施。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-09-01
{"title":"Reverse caps in Medicare encourage primary care, better align incentives.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>If your medical group is seeing specialty costs spiral out of control in Medicare, a reverse capitation arrangement may help. Paying primary care providers fee-for-service--and specialty providers capitation--may better align your group's incentives and promote better use of low-cost primary care services for seniors. See if the methodology is right for you.</p>","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 9","pages":"134-7"},"PeriodicalIF":0.0,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21478254","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}
引用次数: 0
Develop M+C compliance program, or face scrutiny. 制定M+C合规计划，否则将面临审查。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-09-01
{"title":"Develop M+C compliance program, or face scrutiny.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 9","pages":"129-34"},"PeriodicalIF":0.0,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21478253","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}
引用次数: 0
Medicare survey offers data, trends in drug utilization, costs. 医疗保险调查提供数据，药物使用趋势，成本。
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care Pub Date : 1999-09-01
{"title":"Medicare survey offers data, trends in drug utilization, costs.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80144,"journal":{"name":"Public sector contracting report : the monthly guide to Medicare and Medicaid managed care","volume":"5 9","pages":"142-3"},"PeriodicalIF":0.0,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21478257","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}
引用次数: 0
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