How managed care organizations develop selective contracting networks for psychiatric inpatient care: a Massachusetts case study

Article Abstract:

The changes in Medicaid policies have required the adoption of cost and use controls among psychiatric care services. The case study, which focused on Massachusetts, provided a description of the process by which hospitals created an inpatient network to ensure the continued provision of quality care among psychiatrically disabled patients. Breadth of experience is a good indicator of a hospital's inclination to participate in the bidding and their chances of winning. Meanwhile, it was noted that reimbursement rate was not one of the significant criteria in the selection process.

Psychiatric hospitals, Psychiatric and Substance Abuse Hospitals, Public Mental Health Facilities, Case studies, Services, Psychiatric services, Mental health services, Massachusetts, Managed care plans (Medical care), Medicaid

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Power tilt

Article Abstract:

The proposed merger between Health Systems International and WellPoint Health Networks may cause other health plans to seek merger partners in order to maintain a share of the power. It is important to increase market share and propose the best health care plans for employers but there must be consideration for physicians and hospitals in these plans. A balance between providers and health plans are in everyone's interest.

Health aspects, Column, California

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Dealing direct; if you want to play in the big leagues of direct contracting, pay attention to these risks

Article Abstract:

Healthcare providers who enter into direct contracting arrangements will confront several risks. They may face a decrease in their patient load through market retaliation by insurance companies and managed care organizations. Bankruptcy may result from unexpected losses and unpaid bills. The uncertainty and intricacy of the market is also an issue to confront.

Health Care

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