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Essay / Research Paper Abstract
A 4 page research paper that looks at issues relating to managed care organizations (MCOs) and contracts with providers. For better or worse, healthcare in the U.S. is dominated by the logistics of managed care organizations (MCOs) that have extensive legal departments, which safeguard their company's interests. This reality necessitates that healthcare practitioners should, likewise, be knowledgeable about legal issues and contractual obligations. The writer discuses several issues. Bibliography lists 5 sources.
Page Count:
4 pages (~225 words per page)
File: D0_khmcocon.rtf
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Unformatted sample text from the term paper:
This reality necessitates that healthcare practitioners should, likewise, be knowledgeable about legal issues and contractual obligations. For example, experts say that, even if a practitioner is in a solo practice
or a small group, negotiation with an MCO is possible and "creating leverage" can aid in building a "long-term, beneficial relationship with an MCO" (Schulz and Van Wagner 35).
Foregoing the opportunity for negotiation and simply signing a contract because the healthcare practitioner assumes that it is a "standard" contract that is typically signed by his/her peers is not
only "dubious business practice," but ignores the opportunity "to create real value" for a practice (Schulz and Van Wagner 35). A practitioner working in a small practice may feel that
they lack the prestige or leverage necessary for negotiation, but experts urge them not to take this stance. MCO representatives frequently have the authority to institute changes in contracts; however,
they do not generally disclose this fact. "If you dont ask, you wont get" (Schulz and Van Wagner 35). It is true that a practitioner may not receive all the
changes requested, but experts say that most MCO representatives will listen and they rarely take a "we-wont-change-anything" stance, particularly in regards to changes that are mutually beneficial (Schulz and Van
Wagner 35). It is also suggested that the practitioner should, of course, thoroughly read the contract, but also that practitioners should endeavor to find out everything possible about the
MCO. "Due diligence is the sine qua non" of good negotiation and it is especially significant in the context of a managed care setting (Schulz and Van Wagner 35). It
is imperative to ensure that the MCO is not only reputable and financially sound, but also that it delivers on its promises (Schulz and Van Wagner 35). Experts advise: "Do
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