Medicare Psos

副标题: Assessing the Market, Risks And Opportunities

ISBN: 9780929156293

出版社: American Hospital Association

出版年: 1997-01

定价: USD 89.00

装帧: Paperback

内容简介

Congress has opened the lucrative managed Medicare market to hospitals and physician groups that form provider-sponsored organizations (PSOs). But this can be a risky market. Numerous HMOs launched Medicare risk plans and product lines only to abandon them after losing market share and suffering serious financial losses. And these HMOs knew how to deal with HCFA and state regulators!Deciding whether to form a PSO requires a full analysis of the Medicare market, careful planning, and an understanding of the financial management and capital formation issues entailed in a PSO. Then there are the critical organizational issues involving managed care expertise, financial projections, capital needs, internal staff capabilities, network development and other factors that will make or break a PSO.This valuable book provides a blueprint for deciding whether to create a PSO. You'll have at your fingertips comprehensive Medicare trends and market data, important sociodemographic information, and intelligence on the competition, including an invaluable local market opportunity assessment tool. Federal and state regulatory hoops and hurdles are addressed, including important solvency, tax, antitrust and fraud issues. Financial management and reporting, plus capital formation needs, are outlined. Finally, a five-step guide takes you through the decision-making process. The book also contains the text of the federal laws that PSOs and other private Medicare health plans must comply with.