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Doody's Review ServiceReviewer: Patrick Tosetti, MD (University of Chicago Pritzker School of Medicine)
Description: This is an overview of the structure of various managed-care health care delivery systems.
Purpose: The authors' hope is to educate practitioners and their staff members about the ground rules and structure of medical practice under managed care. The book is a manual and reference for practices to use as they adapt to the new medical marketplace. The material covered includes information that persons involved in health care will have to learn.
Audience: The intended audience is physicians and their administrative staff members, not hospitals or managed care organizations. The authors specifically target private practice physicians and their office staff members. The authors are not physicians, but they are very experienced in practice management and have published widely in that field.
Features: The book is a handbook, not an exhaustive reference. It has no illustrations and does not cite the medical literature. It is more of a how-to book, based on the authors' experience and knowledge of managed care. They present some topics in outline form only; with others they make use of tables and examples of actual managed care contracts. The book has a detailed table of contents and index. It is easy to read.
Assessment: This book would be a valuable starting point for any physician or office manager whose practice will be involved in negotiations with managed care networks. It describes the important features of such systems, warns providers of the pitfalls of various structures, and tells them when to get professional assistance. The material in this book is the minimum that those in a busy clinical operation should master.