Homework: Negotiating Contract- Regulatory Environment in Health Care
Directions
Complete the homework beginning page 492 titled "Exercise: Negotiating a Managed Care Contract" in a one to two page paper. Submit the homework to your instructor. For a general description of Marcus Welby Hospital see page 369 of the text. The homework below makes some adaptations to the text to clarify expectations for your paper.
One of Marcus Welby Hospital 's (MWH) competitors established a successful IPA-model HMO two years ago. Fearing loss of patients, MWH is forming the Marcus Welby Managed Care Network (the Network). The objective is to sign up a number of physicians, mainly in primary care but also in common specialties, and then to market this network to these two sources: () large employers who provide health insurance to their workers on a self-insured basis; and 2) large regional or national insurance companies (such as Blue Cross) who then offer the network to their customers.
The Network is approaching each physician group individually and asking them to sign up nonexclusively, leaving them free to sign up with other networks or HMOs. The contract excerpts on pages 493 and following contain some common sticking points in these negotiations. Read each pairing of contract options and determine what is at stake. Then, assume the position of lawyer/negotiator for either (i) the Network or (ii) a physician group who wants to sign up but is concerned about the details.
a. Write in your paper what you would say in a meeting with a representative from the other side and
b. Describe how you would hammer out a deal, either adopting one version or the other, or making any changes you want.
c. You must therefore be able to write clearly about what the concerns of the other side would be.
Format your homework according to the give formatting requirements:
a. The answer must be double spaced, typed, using Times New Roman font (size 12), with one-inch margins on all sides.
b. The response also includes a cover page containing the title of the homework, the course title, the student's name, and the date. The cover page is not included in the required page length.
c. Also include a reference page. The references and Citations should follow APA format. The reference page is not included in the required page length.
Reference
The Law of Health Care Finance & Regulation-Vitalsource.