<p>Today's practicing physicians tend to feel hemmed in by the pressures to align with other entities imposed upon them through the changing structures in health care. The dilemma is not so much of whether or not to merge in some manner with other entities; rather, it is more about how to negotiate from a position of strength in order to practice medicine under the best possible circumstances. -How do physicians hold a strong place at the bargaining table? What strategies can be embraced in creating alignment with other physicians, and how do you get started? -What are the benefits and challenges of physician alignment outside of a hospital relationship? -What are the alignment options and how does each option fit in with the future of healthcare, i.e. ACOs, CINs, risk-based payer contracts, etc.? Physicians at the Bargaining Table: Alignment, Clinical Integration, Value-based Contracting and Population Health Management is written to aid in the decision-making for physicians. This book, available in print and in eBook, is designed for physicians, hospital administrators, practice administrators and office managers, and healthcare consultants. Through the assimilation of reliable and unbiased information, providers can assess their best alternatives. The objectives are to help the reader understand the available alignment options and how these options fit in with the future of healthcare, including accountable care organizations and risk-based payer contracts. This assessment will encompass the benefits and challenges of physician alignment outside of a hospital relationship. Readers will also be able to identify the critical success factors in a successful alignment model; develop strategies related to creating a new alignment relationship with other physicians or investors, and, determine, as a key stakeholder, how to be involved in the process from concept to implementation and beyond. The evidence delivered in this book through the study of alignment options and strategies, resolutions for a successful future state, and reliable case studies will enable the reader to take the next step toward alignment, based on an informed perspective. Table of Contents Chapter 1 Current Industry Changes and Challenges Chapter 2 Specific Alignment Options for Medical Practices Chapter 3 Components of a Successful Alignment Model Chapter 4 Strategies to Address Alignment Related Issues and Concerns Chapter 5 Onward Toward a Successful Future State. Chapter 6 Case Studies Chapter 7 Summary</p>

Physicians at the Bargaining Table: Alignment, Clinical Integration, Value-based Contracting and Population Health Management

Medical Books

Ellis M. (Mac) Knight

Coker Group

MD and Max Reiboldt

Administration & Medicine Economics

Greenbranch Publishing

<p>This handbook enables your organization to systemize the tedious, ongoing, and mandatory process of credentialing your medical staff and to understand why you must! Healthcare organizations lose substantial revenue when providers on their medical staff are not properly credentialed. Payers have unique requirements for providers to satisfy before they will pay for services. Hospitals often face difficulty in getting the information from the provider and are challenged by a lack of systems for initial and ongoing verification and documentation. Administrators must weigh the cost benefits of in-house or outsourced credentialing and evaluate the options for software and other tools. Readers who use this handbook will feel confident and secure in their knowledge.  Expanded description for online store: Healthcare organizations must have credentialed medical staffs to deliver their services. The reasons are two-fold: First, educated, licensed, experienced, and proven caregivers ensure that a hospital or medical practice is capable of delivering quality care. Secondly, payers require that the physicians and other licensed healthcare professionals are qualified and licensed to work with their patients. Before receiving payment for services, the provider must have specific credentials for providing that service. Verifying and documenting the credentials of a healthcare provider is tedious, ongoing, and mandatory. An organization with a large medical staff may struggle with keeping the credentialing function current, as many licenses have rolling expirations. Credentialing ensures that clinical practitioners are duly qualified, licensed, and board certified. It reports the history of malpractice claims, state-instituted sanctions, or other undesirable professional circumstances of providers. Credentialing and privileging of healthcare professionals protects patients and hospitals by minimizing the risk of medical errors that may result from the work of incompetent providers. It also undergirds the reputation and credibility of the institution in the eyes of providers and across the healthcare community. Further, credentialing with insurers forms the basis for reimbursement for professional services. Without the acceptance of the professional credentials of a provider, insurers and other third-party payers will not compensate his or her claims. The purpose of this book is to explain the necessity and to provide the process for the official documentation of each practitioner. The information presented in these chapters will serve as a practical resource for strengthening your organization s credentialing function. Book Features! -Outlines the necessity for credentialing in the delivery of care and in attaining reimbursements for services provided -Explores options for in-house and outsourced credentialing function -Provides systematic process for ongoing credentialing operations Table of Contents Chapter 1: Credentialing The Foundation for Quality and Safety Chapter 2: Types of Credentialing Chapter 3: The Pros and Cons of Outsourcing Credentialing Chapter 4: Regulatory Requirements Chapter 5: Automated Payer and Medical Staff Credentialing System Chapter 6: Training for the Credentialing Function Chapter 7: Conclusion The Importance of the Credentialing Process</p>

The Handbook for Credentialing Healthcare Providers

FACHE

FACP

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Books by Ellis M. (Mac) Knight