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Health Plans Unmasked : A Physician's Guide to Working with Health Insurers / Martin Lustick.
- Format:
- Book
- Author/Creator:
- Lustick, Martin, 1956- author.
- Language:
- English
- Subjects (All):
- Health insurance.
- Health insurance--United States.
- Health insurance claims--United States.
- Health insurance claims.
- Physical Description:
- 1 online resource (177 pages)
- Edition:
- First edition.
- Place of Publication:
- Baltimore, Maryland : Johns Hopkins University Press, [2023]
- Summary:
- "This book is written for leaders of provider organizations as a strategic guide to value-based contracting with health plans. In this book the author describes why insurance companies do the things they do, in order to help show ways to approach them efficiently and successfully. The book also describes how providers can put the pieces in place to make transitions to value-based care as painless as possible"-- Provided by publisher.
- Contents:
- Historical context
- What is a health plan?
- Medicare
- Medicaid
- Commercial insurance
- Brokers and consultants
- The ABCs of fee-for-service
- What happens to a claim
- Payment errors
- Health plan strategic concerns
- Analytics
- Cost management strategies
- Quality
- Care management
- Health plan committees
- Health plan contracting 101
- Value-based budgeting
- Incentive payments
- Risk mitigation
- Price transparency
- Subrogation
- Pharmacy benefit management
- On becoming a payvider
- Closing thoughts.
- Notes:
- Description based on publisher supplied metadata and other sources.
- Description based on print version record.
- Includes index.
- Other Format:
- Print version: Lustick, Martin Health Plans Unmasked
- ISBN:
- 9781421446776
- 1421446774
- OCLC:
- 1381712667
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