Managed Care Contracts-The Professional Association of Specialty Physicians

Managed Care Contracts

The Professional Association of Specialty Physicians (PASP)
has hired you as the membership manager. PASP has been incorporated for 25
years and during that time has grown from a membership of 100 physicians and
one staff member to a membership of 1000 physicians and four staff members. The
other staff members include an executive director and a controller who both
have recently been hired.

The PASP board of directors wants to have a membership
growth of 10% within the next year while retaining current members. Your
position was newly created to accomplish this.

PASP is a physician specialty association and represents
another membership fee that physicians must choose to pay because membership is
voluntary and does not affect their relicensure. Physicians need to feel they
are getting a good return on their investment both in joining and maintaining
their membership because of issues of increasing competition from other
specialists, challenges in getting reimbursement for services rendered, and
managed care contracts that keep them very busy with the increase of the number
of patients they must see.

Assignment:

Managed care has had a profound impact on the way healthcare
is delivered and paid for in the U.S. The physician members of PASP will be
significantly impacted by managed care. Any membership marketing pieces that
PASP creates must reflect that PASP understands the challenges that managed
care poses for its members. PASP should also be able to identify ways that
members of PASP can get help in meeting these challenges. You believe that
specialty physicians just leaving residency and setting up their practices is
one possible market for new members. You have compiled a list of these
physicians and will e-mail them a link asking that they accept a free 8-week
e-mail subscription of a weekly electronic “tip of the week” to help
increase their awareness of key terms used by managed care organizations.

Identify eight managed care contracting terms and write a
brief definition of each term. Remember to cite all sources and be sure to
write each definition using your own words.

Explanation & Answer

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