REVIEWED BY PHILIP J. KANT, PhD
Managed Care Contracting: Concepts and Applications for the Health Care Executive
Douglas Conrad, Robert Bonney, Michael Sachs, and Robert Smith
Health Administration Press, Chicago
1996, 146 pp., $36 (paperback)
With the continuing growth of managed care in the commercial market, and with Medicare and Medicaid both moving rapidly in that direction, every healthcare executive has been exposed to speeches, articles, and textbooks about managed care. Is there really a need for another such book? My answer, after reading Managed Care Contracting, is yes. This book offers a clear and succinct theory of strategic approaches, while providing practical checklists and sample documents.
Writing from a strategic point of view, the authors advise that we view managed care contracting not as an event but rather as part of a process. First, healthcare executives must understand why they are changing, and then develop a strategy for approaching that change. After reviewing and understanding the options available, they can begin moving forward.
Each chapter takes the reader through this process step by step, providing insights and ideas along the way. Tables and charts illustrate each section's message. Examples throughout further understanding of the key points. The messages are clear and organized; the reading is focused and complete. The appendixes provide practical guidelines, including a list of questions to ask before signing managed care contracts, a list of terms used in contracts, and sample agreements between a plan and a hospital.
Although readers will not learn everything they need to know about managed care in just over 100 pages, this book is a great summary and resource for healthcare executives, particularly those responsible for developing the organization's strategic response to the movement toward managed care.
Philip J. Karst, PhD
Associate Director, Network Services
Catholic Charities of St. Louis