Description: Risk Contracting and Medicare-Plus Choice, edited by Winfield Towles, M.D., and Charlotte Collins, J.D., is your all-in-one guide to understanding the details and implications of the Medicare-Plus Choice program and accompanying provider-sponsored organization (PSO) legislation. It is a comprehensive reference that provides a framework for understanding how health delivery systems operate under Medicare risk contracts, and describes the questions providers must answer before deciding to become a risk-bearing contractor.

Risk Contracting and Medicare-Pitts Choice, discusses Medicare managed care, the role of the risk contractor in the health delivery system and the fundamental characteristics of the Medicare-Plus Choice Program. It also details the various financing mechanisms associated with Medicare-Plus Choice, and addresses issues pertaining to licensure, solvency and the other legal-regulatory requirements for establishing Medicare-Plus Choice risk contracts. The book concludes with a summary of the opportunities offered to PSOs through Medicare-Plus Choice and a valuable appendix that contains:
-- Operational policy letters from the Health Care Finance Administration (HCFA)
-- Sample applications for Medicare-Plus Choice organizations
-- Sample waivers from state licensure for PSOs and solvency requirements
-- Excerpts from HCFA manuals and the National Marketing Guidelines
-- Model work plans for setting up Medicare-Plus Choice Plans and model provider contracts

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