Health plans unmasked : a physician's guide to working with health insurers

Lustick, Martin 1956- (author.).

Summary: "This book is written for leaders of provider organizations as a strategic guide to value-based contracting with health plans. In this book the author describes why insurance companies do the things they do, in order to help show ways to approach them efficiently and successfully. The book also describes how providers can put the pieces in place to make transitions to value-based care as painless as possible"--

Record details

ISBN: 9781421446776
ISBN: 1421446774
Physical Description: 1 online resource
remote
Publisher: Baltimore : Johns Hopkins University Press, 2023.

Content descriptions

Bibliography, etc. Note:	Includes bibliographical references and index.
Formatted Contents Note:	Historical context -- What is a health plan? -- Medicare -- Medicaid -- Commercial insurance -- Brokers and consultants -- The ABCs of fee-for-service -- What happens to a claim -- Payment errors -- Health plan strategic concerns -- Analytics -- Cost management strategies -- Quality -- Care management -- Health plan committees -- Health plan contracting 101 -- Value-based budgeting -- Incentive payments -- Risk mitigation -- Price transparency -- Subrogation -- Pharmacy benefit management -- On becoming a payvider -- Closing thoughts.
Restrictions on Access Note:	NLC staff and students only.
Source of Description Note:	Description based on online resource; title from digital title page (ProQuest Ebook Central, viewed May 8, 2024).