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Performance-based Contracting for Health Services in Developing Countries

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Author : Benjamin Loevinsohn
Publisher : World Bank Publications
ISBN 13 : 0821375377
Total Pages : 226 pages
Book Rating : 4.8/5 (213 download)

Book Synopsis Performance-based Contracting for Health Services in Developing Countries by : Benjamin Loevinsohn

Download or read book Performance-based Contracting for Health Services in Developing Countries written by Benjamin Loevinsohn and published by World Bank Publications. This book was released on 2008-01-01 with total page 226 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite the existence of effective interventions, there are many developing countries which are not on track to achieve the Millennium Development Goals (MDGs) for health. In many countries the delivery of health services is inadequate and one way of improving the situation is to contract with non-state providers. Contracting is a mechanism for a financing entity to procure a defined set of services from a non-state provider. Performance-based contracting is a type of contracting with: (a) a clear set of objectives and indicators; (b) systematic efforts to collect data to judge contractor performance; and (c) some consequences for the contractor, either rewards or sanctions, based on performance. Effective contracting for health services can be facilitated by using a systematic approach, described in this toolkit, that addresses key issues, including how to: 1. have a constructive dialogue with all stakeholders; 2. define the health services in terms of what services are to be delivered, where, the quantity of beneficiaries to be served, equity, and quality of care; 3. design the monitoring and evaluation to judge the performance of contractors; 4. select the contractors in a fair and transparent way; 5. arrange for effective contract management; 6. draft the contract and bidding documents; and 7. carry out the bidding process and successfully manage the contracts. The toolkit also includes a review of 14 evaluated examples of contracting in developing countries which concludes that the current weight of evidence indicates that contracting improves the coverage and quality of services rapidly. The six cases with controlled, before and after evaluations demonstrated large impact with themedian double difference (follow-up minus baseline in the experimental group minus follow-up minus baseline in the control) ranging from 9 to 26 percentage points.

The Managed Care Contracting Handbook

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Author : Maria K. Todd
Publisher : CRC Press
ISBN 13 : 1439866570
Total Pages : 334 pages
Book Rating : 4.4/5 (398 download)

Book Synopsis The Managed Care Contracting Handbook by : Maria K. Todd

Download or read book The Managed Care Contracting Handbook written by Maria K. Todd and published by CRC Press. This book was released on 2009-03-26 with total page 334 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don‘t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what contingencies to cover ... and when to ask a lawyer

Health Care Choices

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Author : Clark C. Havighurst
Publisher : American Enterprise Institute
ISBN 13 : 9780844738673
Total Pages : 364 pages
Book Rating : 4.7/5 (386 download)

Book Synopsis Health Care Choices by : Clark C. Havighurst

Download or read book Health Care Choices written by Clark C. Havighurst and published by American Enterprise Institute. This book was released on 1995 with total page 364 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text argues that private contracts would allow for more and genuine consumer choice, based on real differences between competing health plans in content, mixture and cost of services. It further argues that contracts would establish set standards and obligations for all parties.

Summary of Grants and Contracts

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Author : National Center for Health Services Research
Publisher :
ISBN 13 :
Total Pages : 244 pages
Book Rating : 4.:/5 (319 download)

Book Synopsis Summary of Grants and Contracts by : National Center for Health Services Research

Download or read book Summary of Grants and Contracts written by National Center for Health Services Research and published by . This book was released on 1975 with total page 244 pages. Available in PDF, EPUB and Kindle. Book excerpt: Eighth edition, contains all projects active on June 30, 1975.

VA Health Care

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Author : United States. General Accounting Office
Publisher :
ISBN 13 :
Total Pages : 24 pages
Book Rating : 4.:/5 (31 download)

Book Synopsis VA Health Care by : United States. General Accounting Office

Download or read book VA Health Care written by United States. General Accounting Office and published by . This book was released on 1992 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Summary of Grants and Contracts Active on ...

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Author : National Center for Health Services Research
Publisher :
ISBN 13 :
Total Pages : 244 pages
Book Rating : 4.3/5 (91 download)

Book Synopsis Summary of Grants and Contracts Active on ... by : National Center for Health Services Research

Download or read book Summary of Grants and Contracts Active on ... written by National Center for Health Services Research and published by . This book was released on with total page 244 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Contract Medical Services

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Author : United States. Congress. House. Committee on Veterans' Affairs. Subcommittee on Oversight and Investigations
Publisher :
ISBN 13 :
Total Pages : 64 pages
Book Rating : 4.3/5 (121 download)

Book Synopsis Contract Medical Services by : United States. Congress. House. Committee on Veterans' Affairs. Subcommittee on Oversight and Investigations

Download or read book Contract Medical Services written by United States. Congress. House. Committee on Veterans' Affairs. Subcommittee on Oversight and Investigations and published by . This book was released on 1987 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Improving the Medicare Market

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Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309175364
Total Pages : 384 pages
Book Rating : 4.3/5 (91 download)

Book Synopsis Improving the Medicare Market by : Institute of Medicine

Download or read book Improving the Medicare Market written by Institute of Medicine and published by National Academies Press. This book was released on 1996-11-01 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.

Contract Management of Medical Services

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Author : Great Britain: National Audit Office
Publisher : The Stationery Office
ISBN 13 : 9780102977288
Total Pages : 40 pages
Book Rating : 4.9/5 (772 download)

Book Synopsis Contract Management of Medical Services by : Great Britain: National Audit Office

Download or read book Contract Management of Medical Services written by Great Britain: National Audit Office and published by The Stationery Office. This book was released on 2012-10-18 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Department for Work and Pensions relies on medical assessments to help its decision makers reach an appropriate decision on a customer's entitlement to a wide range of benefits. From April 2013, a new medical assessment will be introduced for Personal Independence Payment. A procurement competition is underway to appoint service providers for this. The Department's contractor for medical services, Atos Healthcare, completed 738,000 face-to-face medical assessments in 2011-12 and charged the Department £112.4 million. This performance review examines the Department's contract management and wider strategy for the supply of medical services, including the Department's contractual relationship with Atos Healthcare; the performance management of Atos Healthcare; the future contracting strategy. Amongst key findings, according to the performance data provided, is that Atos Healthcare has not routinely met all the service standards specified in the contract. This report makes a number of recommendations to strengthen existing governance arrangements; to improve performance monitoring and to strengthen the Department's commercial strategy

Access to Health Care in America

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Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309047420
Total Pages : 240 pages
Book Rating : 4.3/5 (9 download)

Book Synopsis Access to Health Care in America by : Institute of Medicine

Download or read book Access to Health Care in America written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.

Summary of Grants and Contracts Administered by the National Center for Health Services Research and Development

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Author : National Center for Health Services Research and Development. Office of Inter-Organization Relations
Publisher :
ISBN 13 :
Total Pages : 332 pages
Book Rating : 4.:/5 (319 download)

Book Synopsis Summary of Grants and Contracts Administered by the National Center for Health Services Research and Development by : National Center for Health Services Research and Development. Office of Inter-Organization Relations

Download or read book Summary of Grants and Contracts Administered by the National Center for Health Services Research and Development written by National Center for Health Services Research and Development. Office of Inter-Organization Relations and published by . This book was released on 1971 with total page 332 pages. Available in PDF, EPUB and Kindle. Book excerpt: Eighth edition, contains all projects active on June 30, 1975.

Managed Care Contracting

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Author : William A. Garofalo
Publisher : Jossey-Bass
ISBN 13 : 9780787945817
Total Pages : 0 pages
Book Rating : 4.9/5 (458 download)

Book Synopsis Managed Care Contracting by : William A. Garofalo

Download or read book Managed Care Contracting written by William A. Garofalo and published by Jossey-Bass. This book was released on 1999-01-06 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Today's heath care marketplace is highly competitive, requiring managed care providers to contract with dozens of insurers to survive. Each of these contracts comes with their its unique terms and conditions-making the contracting process overwhelmingly complex and giving many health care executives major headaches. Written by three of the country's leading health care consultants and attorneys, Managed Care Contracting is the first book to offer executives with no legal background practical, step-by-step advice on how to create winning contracts between health care organizations, payers, and employers. In straightforward language, free of legalese and jargon, this much-needed resource demystifies managed care contracting and prescribes some critical advice for hospital and physician group practice executives. The authors present helpful guidelines for evaluating the various types of managed care contracts and explain the most significant terms and concepts executives are likely to encounter. A treasure trove of information for health care executives no matter what their experience level, Managed Care Contracting Examines how to develop a contracting strategy Reviews the fundamentals of negotiating the contract Frames the key steps in the contracting process Provides a managed care contract negotiations checklist Dissects sample hospital and physician contracts Analyzes the contract risk factors by the type of payment explores the implications of changing financial incentives Outlines the most up-to-date information in the regulatory environment Includes illustrative examples and helpful tables and chartsFor health care executives who are just beginning the complex contracting process and for the more experienced who require the most current information on the topic, Managed Care Contracting provides the knowledge and tools they need to succeed. "Managed Care Contracting is a very timely

Medical and Dental Expenses

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Author :
Publisher :
ISBN 13 :
Total Pages : 20 pages
Book Rating : 4.:/5 (3 download)

Book Synopsis Medical and Dental Expenses by :

Download or read book Medical and Dental Expenses written by and published by . This book was released on 1990 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:

The Managed Care Contracting Handbook

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Author : Maria K. Todd
Publisher : CRC Press
ISBN 13 : 1040081118
Total Pages : 211 pages
Book Rating : 4.0/5 (4 download)

Book Synopsis The Managed Care Contracting Handbook by : Maria K. Todd

Download or read book The Managed Care Contracting Handbook written by Maria K. Todd and published by CRC Press. This book was released on 2009-03-26 with total page 211 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don‘t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what contingencies to cover ... and when to ask a lawyer

How to Open & Operate a Financially Successful Medical Billing Service

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Author : Laura Gater
Publisher : Atlantic Publishing Company
ISBN 13 : 1601382804
Total Pages : 290 pages
Book Rating : 4.6/5 (13 download)

Book Synopsis How to Open & Operate a Financially Successful Medical Billing Service by : Laura Gater

Download or read book How to Open & Operate a Financially Successful Medical Billing Service written by Laura Gater and published by Atlantic Publishing Company. This book was released on 2010 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: Book & CD-ROM. If you are detail-oriented, want to be your own boss, and would like to act on the behalf of physicians all over the country, the medical billing service business could be a right fit for you. Whether you will be operating out of your home or you are looking to buy or rent office space, this book can help you with a wealth of start-up information, from how to form and name your business to deciding if this will be a joint venture or if you would rather work solo. Valuable information on forming a Partnership, LLC, Corporation, or becoming a Sole Proprietor, the four types of business formation, is included, as well as the legal implications of each. A complete list of all of the start-up equipment that you will need is provided, as well as a sample budgeting sheet to allow you to gauge start-up costs. You will learn about potential risks that you take in opening a medical billing service and why it is important to have business insurance. You will find information on the operations side of running your business from filling medical billing claims to receiving payments, along with privacy information that you will need to know such as HIPPA. Included is a glossary with all of the medical billing terms that you will need in order to knowledgeably run your business, alongside a complete listing of procedural codes and a directory of insurance carriers. You will learn about each of the covered services in the medical field, along with other major medical industries such as, psychiatric, dental, durable medical equipment, and pharmacy. This complete manual will arm you with everything you need, including sample business forms; contracts; worksheets and checklists for planning, opening, and running day-to-day operations; lists; plans and layouts; and dozens of other valuable, timesaving tools of the trade that no business owner should be without. A special chapter on the different types of billing software that you should buy is included, as well as how much it will cost you and how to set up and use the software to save time and money. While providing detailed instruction and examples, the author leads you through every detail that will bring success. You will learn how to draw up a winning business plan (the companion CD-ROM has the actual business plan you can use in Microsoft Word) and about basic cost control systems, copyright and trademark issues, branding, management, legal concerns, sales and marketing techniques, and pricing formulas. You will learn how to hire and keep a qualified professional staff, how to meet IRS requirements, how to manage and train employees, how to generate high profile public relations and publicity, and how to implement low cost internal marketing ideas. You will learn how to build your business by using low and no cost ways to satisfy customers, as well as ways to increase sales, have customers refer others to you, and thousands of great tips and useful guidelines.

An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies

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Author : Sara Rosenbaum
Publisher :
ISBN 13 :
Total Pages : 74 pages
Book Rating : 4.:/5 (327 download)

Book Synopsis An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies by : Sara Rosenbaum

Download or read book An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies written by Sara Rosenbaum and published by . This book was released on 1997 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Contracting for Managed Substance Abuse and Mental Health Services

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Author : Stephen Moss
Publisher :
ISBN 13 :
Total Pages : 320 pages
Book Rating : 4.:/5 (319 download)

Book Synopsis Contracting for Managed Substance Abuse and Mental Health Services by : Stephen Moss

Download or read book Contracting for Managed Substance Abuse and Mental Health Services written by Stephen Moss and published by . This book was released on 1998 with total page 320 pages. Available in PDF, EPUB and Kindle. Book excerpt: