Physician-Sponsored Network (PSN)

With respect to the organization of a managed c be network, three major force fields of engage are reviewed. These participation areas are licensure, wellness tutorship service distribution channels, and the dialogue of participation agreements. These three areas are not the only ones that must be dealt with in the organization of a PSN, but they are the areas that hold the greatest potential for the making of critical mistakes. The richness of these three interest areas justifies their emphasis in this newsprint. The reviews of each of these interest areas are summarized in the following discussions.

A PSN is comprised of qualified and licensed physicians. That these physicians required licenses to put medicine is understood by all. Depending upon the areas of differentiation of a PSN, the physician members of the organization also must be certified by the appropriate medical specialty tabular array or organization. Further, a PSN must obtain an ordinary line of work license to operate in a given city or county. Licenses of these types, while of the essence(predicate) and necessary, also are routine.

The area of licensing that is crucial for PPOs of all kinds involves antitrust fairness. Quite simply, antitrust law is intended to prevent unfair emulation in either field of economic activity. One of the key aspects of unfair competition is outlay-fixing by those organizations participating in a market. PSNs run the danger of being charged

An important characteristic of most managed tuition networks is that the amount of payment for the health care services to be delivered by a PPO are set before the services are delivered. This approach to compensation for services means that compensation for the services provided to all patients suffering from a specific worry, as an example colon cancer, result be the same. Within the group of patients suffering from colon cancer, however, some(a) go forth require more services than the average, while others allow for require less services than the average. The critical problem for a PPO is to assure that the planned average level of compensation is not exceeded in actual practice. One approach to solving this problem is case management.

The issue of motives is important because participants in health care affiliation negotiations often distrust the motives of the other party. Motives must be among the first issues discussed.

The information management issues involved with the creation and alimony of information systems are reviewed in the (Information Management( sub-section in the paper.

Both the issues surround the concept of purchase-oriented management and specific procedures used in the practice of purchaser-oriented management by managed care networks are covered in the (Purchaser-Oriented Management( sub-section in the paper.

Developing Competitive Advantage Summary

The (Licensure( sub-section in this paper examines in some detail the problems that must be whelm by a PSN in order to assure that the federal official Department of Justice and the Fair Trade Commission will not charge the organization with price-fixing, thereby denying the PSN to authorization to operate. Managed care organizations typically depend upon some form of capitation scheme for price setting and fee collection. The (Licensure( sub-section of this paper describes the things that a PSN must do during the organization phase to avoid antitrust charges related to fee-settin
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