The development and management of medical groups /

Bibliographic Details
Main Author:	Benedict, Gerald S.
Format:	Book
Language:	English
Published:	Englewood, CO : Chicago, IL : Medical Group Mangement Association ; American Medical Association, [1996]
Subjects:	Group Practice > organization & administration. Practice Management, Medical > organization & administration.

Table of Contents:

The development of medical groups
Introduction
Historical background
What is a medical group
Origins of medical groups
The mayo clinic
The early 20th century
Prepaid medical groups
Physician management companies
Forms of medical groups
Forces driving physicians to medical groups
Growth of managed care
Health care as big business
Changed health care environment
Shift to outpatient and physician care
Changed incentives under capitation
What about quality
Medical group managed care tools.
Medical group managed care performance
Deteriorating practice economics
Declining rate of premium increases
The need for capital
Affiliating with a capital partner
Barriers to medical groups affiliating with hospitals
The "bidding wars" for primary care physician practices
Benefits of medical groups for physicians
A sharing environment
The benefits of large medical groups
Higher primary care physician incomes in medical groups
Shared medical group income
Retention of revenues generated by medical groups.
Reduced physician risk for group operations
Reduced practice startup costs
Other benefits
Forming a medical group
Letters of interest
Establishment of a steering committee
Development of a group formation work plan
Phase I: Feasibility assessment
Group vision and guiding principles
Physician selection criteria and mix
Practice profiling
Practice asset valuations
Market assessment
Initial financial assessment
Phase 2: Business planning
Legal structure
Ownership
Governance
Physician work effort standards.
Business plan and budgets
Legal documents
Phase 3. pre-implementation
Management
Allocation of decision making and responsibilities
Practice merger proposals
Site planning
Implementation plan
Phase 4: Implementation
Office consolidation
Operations
Management information systems
Managed care systems
Contracting and marketing
The management of medical groups
Introduction
Organization and governance
Medical group culture
The importance of governance
Physician leadership.
Physician organizational experience
Ineffective group managers
Differences between physicians and administrators
The right medical group physicians
Specialist-dominataed multispecialty medical groups
The worst possible guy phenomenon
Medical group economics
Does bigger make better
Group practices without walls
Incurred but not reported claims
Sending out the business
You want my outside income
Lessors vs. lessees
Lack of sharing of group income
Group growth problems
Physician buy ins and buy outs.
Accumulation of medical group reserves
Annual budgets and long-range plans
Physician compensation and benefits
Symptoms of a failing compensation plan
Spending money you don't have
Confuse 'em or lose 'em
The deferred bonus approach
Measuring physician work effort/contributions
Nonproductive physicians
Transitioning from fee-for-service to capitation
Individual vs. group cost accounting
The "sacred formula"
Physician vs. patient satisfaction
Retirement plans
Medical group operations
Medical records always are a problem.
Don't take my nurse away
My priority is more important
Management information systems
Hiring a physician's spouse
Appointment scheduling
Billing for services rendered
Credit and collections
Managed care cost controls
Measurement of effective performance
Conclusion - Appendix A: administration and medical director responsibilities
Appendix B: example of a medical group implementation plan.