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Tổ chức chăm sóc sức khoẻ

Sức mạnh Trồng chăm sóc quản lý ĐÃ Giảm Các Tự chủ tài chính của bác sĩ phẫu thuật Nhiều lâm sàng và chỉnh hình. Luận văn tốt nghiệp trong tay để bù đắp các xu hướng tiêu cực, mối quan hệ mới được phát triển để xác định Là phương pháp của hợp đồng doctorsÕ với sức khỏe các tổ chức bảo trì. | Beyond HMOs Understanding the Next Wave of Change in Health-Care Organization Scott Gottlieb BA and Thomas A. Einhorn MD Abstract The growing strength of managed care has diminished the financial and clinical autonomy of many orthopaedic surgeons. In part to offset these negative trends new relationships are being developed to define doctors methods of contracting with health-maintenance organizations. These include physician practice management companies PPMs independent practice associations management service organizations and physician-sponsored organizations. Each entity offers distinct advantages and disadvantages. While the PPM is the most popular new vehicle to offset adverse market trends it carries with it some of the greatest potential pitfalls. In every case before negotiating to join one of these new entities it is important for a physician to have a solid understanding of the competing claims made by each entity as well as insight into the fiscal health of the particular company in question. For some doctors these arrangements offer a solution to current woes. For others PPMs interpose another meddlesome intermediary in a market already bloated by layers of bureaucracy. J Am Acad Orthop Surg 1998 6 75-83 Managed care has existed for almost three decades and most of the current debate surrounding health-care reform has centered on the application of that concept. For many individuals the term Òman-aged careÓ has become synonymous with health maintenance organizations HMOs . One in five persons with health insurance coverage is presently enrolled in an HMO and at current growth rates nearly one in three persons will be enrolled in an HMO by the year 2000. One result of the increasing presence of managed care is that many physicians in solo and small single-specialty group practices have watched their fee-for-service practices decline. For many doctors HMO patients now constitute a greater portion of their practice base than ever before and for many .