Managed Care Development

At its best, correctional managed care establishes a process for balancing fiscal responsibility on one hand with liability exposure concerns on the other.

The primary purpose of managed care is to regulate the demand for healthcare services and ensure that services are provided only after certain criteria are met.

This is done as a means of controlling costs and allocating budgeted funds in such a manner as to provide necessary care while denying or deferring care that, while desirable from the patient’s perspective, is not urgently needed or does not otherwise reflect a serious underlying medical condition.

As a correctional healthcare administrator for both a government agency and a private managed care company, I have negotiated a wide variety of agreements for professional services provided both on and off-site.

Contractual arrangements for healthcare services can take on many forms, but the key is predictability. While securing a consistent flow of services, a contract also serves as a tool to estimate and limit expenses over time.

Your operation (and budget) could benefit from my background in managed care development, provider relations and service pricing negotiation.