Doody's Review ServiceReviewer: Cynthia L. Nelson, BS (Baylor College of Medicine)
Description: This is the second edition of a handbook on key aspects of today's managed care environment. The book guides the reader through organization types and reimbursement mechanisms, evaluating plans and credentialing, and improving practice productivity and outcomes of care.
Purpose: The purpose is to provide information to help physicians practice under managed care while preserving the essence of the traditional patient-physician relationship. A satisfactory amount of information is provided to allow physicians to make informed choices about plans and reimbursement as well as methods to review outcomes of care. The authors realistically acknowledge "what worked yesterday will not necessarily work tomorrow."
Audience: The handbook is written for primary care and specialty physicians and their office managers. It is useful for physicians who are wary of managed care plans. However, there is not enough detail for an experienced billing and collection manager. The authors have written other pertinent books on physician reimbursement and have many years of experience in practice management consulting.
Features: The examples in the text and appendixes are easy to follow. The index is thorough. Chapter summaries would have been helpful to emphasize key points. References to another book for more detail do not contain enough information to locate the work.
Assessment: Because managed care is a reality affecting medical practices in both urban and rural settings, the authors do not waste space debating the need to consider managed care contracts. The basic "how to" examples guide the physician and medical office staff through what they must know to survive in a managed care environment. The practice management section is particularly useful for physicians, with its emphasis on how to be more productive yet attentive to patient satisfaction. Medical directors and managers of small private or academic practices should buy this book. The handbook is up-to-date on a subject that is changing rapidly.