You can become a player in managed care arena
Here are some tips for negotiating managed care contracts from How to Become a Successful Player in Managed Care: 10 Key Arguments for Family Planning, published in 1997 by the Family Planning Councils of America in Washington, PA:
• Contact the person from your state’s welfare department (or health department) who is responsible for the Medicaid managed care network. He or she can provide a list of all the registered managed care companies operating in your area.
• Ask to meet with the managed care organization (MCO). Try to make arrangements so people who speak the same language meet (so your director meets with the MCO’s officers; your doctors meet with the MCO’s medical director; and your information systems manager meets with the MCO’s claims processing staff).
• Talk to contacts at your referral hospitals. They already have managed care relationships in place and can offer guidance.
• Talk to your local family planning grantee for guidance and support. Often, the grantee can provide information, such as a list of qualified consultants who can help you move into managed care.
• Talk to your community’s welfare rights advocates to obtain the latest word on managed care activities in your area.
(Editor’s note: For links to local advocates, check the Welfare Information Network, www.welfareinfo.org, coordinated by the Washington, DC, Finance Project, a nonprofit policy research, technical assistance, and information organization.)
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