Checkpoint Ramifications of Participation Contracts

Checkpoint Ramifications of Participation Contracts -...

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Checkpoint: Ramifications of Participation Contracts Adrienne Martin HCR/230 Beatrice Johnson
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All providers, employers, and employees need to evaluate a health plan to make sure that it fits their needs financially and according to their needs. Mainly these plans are evaluated on the financial options that are offered to the provider. Because of the fact that managed health care dominates the health care system, medical offices often have many different contracts with different programs in their area. The biggest consideration for health care providers is whether or not the plan will be beneficial to them financially. Plans pay less than what the doctor’s fees are so they make less money for each procedure that is performed. Some plans have very low fees and sometimes even
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Unformatted text preview: having many patients will not help a doctor or medical practice make a profit. Fees are evaluated for each plan based on what the pan will pay for each procedure. If the plan is not profitable then doctors will often not go with that plan even if it brings them a larger clientele. The positive aspect comes from having a plan that is well known and is well advertised because people tend to be more comfortable with a popular and respected plan. The negative aspects are that even though the plan may bring in more business it may not pay enough to cover the fees that it costs the provider and they could still end up losing money that is needed for equipment, supplies, and to pay their staff members....
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This note was uploaded on 02/20/2011 for the course HCR 230 taught by Professor Volk during the Spring '11 term at University of Phoenix.

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Checkpoint Ramifications of Participation Contracts -...

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