Product type:

AllBooksEventsOnline CoursesWebinarsPackages
Medical Group Management Association

Transitioning to Alternative Payment Models: A Guide to Next-Generation Managed Care Contracting

Book -

Strategic Planning

Contracting

Value-Based Operations

SKU: 8917

Overview

This book’s goal is to offer medical practice leadership teams practical guidance on navigating the shift from volume-based to value-based managed care contractual relationships. Medical practices – both independent and affiliated – that understand how their organization can and should position themselves for the future will have a significant advantage over the competition.

Honestly identifying where you are and defining where you want to be begins with developing a clear understanding of national and local market dynamics, identifying potential arrangements within your local market and applying those factors to your organization’s goals. This exercise can ultimately inform your value proposition, which becomes the cornerstone of your managed care contracting strategy.

The book will cover in detail the most common alternative payment models and what your practice should do to prepare for this transition.

Models detailed include:
  • Pay for performance
  • Bundled payments
  • Shared savings
  • Capitation
Chapter 1   Introduction
Chapter 2   Triple Aim
Chapter 3   Narrow Networks
Chapter 4   Patient Liability
Chapter 5   Transparency
Chapter 6   Quality Metrics
Chapter 7   Connecting the Dots
Chapter 8   Fee-for-Service
Chapter 9   Pay for Performance
Chapter 10 Bundled Payments
Chapter 11 Shared Savings
Chapter 12 Capitation
Chapter 13 Setting up to Succeed
Chapter 14 Conclusion
Index
Doral Davis-Jacobsen

Doral Davis-Jacobsen, MBA, FACMPE

Doral Davis-Jacobsen, MBA, FACMPE, is a Partner at Prosper Beyond LLC, a specialized healthcare consulting firm nestled in beautiful Asheville, North Carolina. Doral is a seasoned healthcare consultant with over 20 years of experience serving healthcare providers ranging from solo practitioners to large academic medical centers. She is a popular speaker and author, always looking around the corner to help her clients prepare for “what’s next.” Doral is known for assisting practices with next generation managed care contract negotiations, payment reform and revenue cycle. She is a Fellow in the American College of Medical Practice Executives. Doral serves as the Chair for the North Carolina MGMA Payer Contracting Committee 2019. Doral has written numerous articles on medical practice revenue cycle, managed care contracting and payment reform and is a frequent speaker at national, regional and local healthcare forums. Doral is a co-author of MGMA’s book, Transitioning to Alternative Payment Models: A Guide to Next Generation Managed Care Contracting, published in October 2016.



Nanci L. Robertson, MA

Nanci Robertson is a healthcare consultant specializing in managed care contracting. She has 30 years’ experience working in the healthcare field, with emphasis on negotiating managed care contracts on behalf of physicians, independent practice associations and ancillary providers. Before launching Robertson Consulting, Inc., in 2000, Nanci worked in several clinical positions as a registered nurse. Her managed care experience includes managing and directing the health services, provider relations and contracting departments of Cigna Healthcare of Colorado, Inc. Additionally, Robertson served as the site administrator for Phy-Cor, where she was responsible for implementing full-risk hospital and physician contracts for Medicare and commercial risk products. Most recently, Robertson spends her time putting together the puzzle pieces of healthcare reform. Her primary goal is to assist clients in visualizing how they fit into the big picture in a rapidly changing environment.

Contact MGMA

Contact the MGMA Service Center for cancellations or refunds.

Complaint resolution policy

Please contact the MGMA Service Center toll-free at 877.ASK.MGMA (275.6462) for issues or concerns with this book.

Shipping

Member Pricing: 
MGMA members enjoy FREE standard shipping on all purchases. Simply add FREESHIP to the Promo Code field during checkout.

Standard and express shipping options are available to customers.

  • Standard shipping $9.50 (5-7 business days)
  • Two-day shipping $20.00
  • Overnight shipping $25.00 (excludes Saturday delivery)


MGMA can ship internationally for an additional fee. Please call the MGMA Service Center for a shipping quote.

X

Shopping Cart

Your cart is empty

Subtotal:
Click here if your organization is tax exempt
X

A State Sales tax exempt certificate must be on file and taxable items cannot be ordered online. For immediate assistance during normal business hours of 7:00am to 5:00pm MT M-Th and 7:00 am to Noon MT on Friday, please call toll-free: 877-275-6462, ext. 1888

X

Checkout

Use two letter code for US states
Use three letter code for country
Use two letter code for US states
Use three letter code for country

Grand Total:
Use two letter code for US states
Use three letter code for country
Saved credit card is required for opt-in to autorenew.

Questions? Contact the MGMA Service Center for assistance during checkout or review our return policy for more information.
X

Confirmation

,
,

Total:
Payment:
Balance:
 

Thank you for your purchase! If you purchased an event, you will be receiving a follow-up email from our Learning Management System regarding the product/event purchased and no further action is required.


Loading...