Supplying the advice of a recognized expert in global healthcare, the book provides a detailed and empathic understanding of patient needs and expectations. It covers the full range of best and worst case scenarios that can occur when clients travel to obtain health services. Using a conversational tone, it includes coverage of international travel logistics, where to find answers to immigration concerns, confidentiality/privacy issues, and unanticipated care in transit in the event of complications or missed connections.
The book delivers a fast-moving presentation of useful information and teaches readers how to decode the language, what to look for in terms of safety and quality, how to decode hospital facilitator agent agreements, and how to anticipate clients’ needs and expectations. It also includes access to a regularly updated website with helpful worksheets and reference material so you will be prepared to handle any scenario that might present itself when your clients travel.
Maria K. Todd, MHA, PhD, is the CEO of Mercury Healthcare. Dr Todd's background includes postgraduate degrees in Health Administration, and more than 30 years of healthcare industry experience. Her professional experience includes work as a HMO provider relations coordinator, an Independent Practice Association (IPA), Physician Hospital Organization (PHO), and Management Services Organization (MSO) developer and executive director, contract analyst and negotiator, medical group administrator, surgical assistant and EMT, hospital business office manager, health law paralegal and certified mediator. She is the author of the industry's bestselling book, IPA, PHO MSO Development Strategies: Building Successful Provider Alliances (1997, McGraw Hill and the HFMA, Chicago).
Dr. Todd has led the project management of more than 150 integrated health delivery systems, many still in successful operation today, and is a highly-regarded international healthcare industry consultant and contract negotiator who authored hundreds of journal articles, several white papers and nine professional trade books. Since 1989, she has presented more than 2700 US and International educational presentations and keynote addresses on topics ranging from managed care contract analysis, integrated delivery system development, medical tourism, contracted reimbursement, and global healthcare program development.
In her role with Mercury Healthcare, she leads the world's first and only globally integrated health delivery system® making its vast integrated provider network available by contract to a variety of payers of health benefits, including insurers, third party administrators or employers. Mercury also grants access to individual consumers seeking local care and domestic and international health travel for elective healthcare and related services, and manages logistical coordination and medical case management services for clients.
Details the elements necessary for a successful system Addresses contracting issues likely to arise Includes access to additional resources on the book’s website
Maria K. Todd prepares readers to build the medical tourism service line, integrate physicians and other service providers, develop a safe and effective quality and patient-centered infrastructure, document processes and workflows, determine pricing, evaluate reimbursement contracts, and measure outcomes. She offers useful nuts-and-bolts guidance on confidentiality, documentation, quality and safety, hospital accreditation schemes, revenue implications, and contracting. Sharing time-tested insights, the book will help readers avoid common pitfalls when working with U.S. and international health insurance companies, case managers, professional facilitators, and multinational employers.Read a recent press release about the Handbook of Medical Tourism Program Development:
Written by Maria K. Todd, a seasoned professional in managed care contracting, this handbook is written for managers, analysts, and finance officers who have the daunting task of negotiating contracts for medical services. It offers an in-depth examination of managed care and its organizations and covers key areas, such as pay-for-performance initiatives, reimbursement methods, contract law basics, and negotiating strategies.
The Managed Care Contracting Handbook offers critical details and strategic information as well as resources on everything from HMOs and PPOs to Consumer Driven Health Plans (CDHP), self-funded ERSIA payers, and Medicaid managed care.
Fully updates the first edition, which was used widely in the U.S. and overseas.
Designed to equip you with the confidence that comes with knowing the right questions to ask and more answers than you are supposed to know, this easy-access resource —Provides a complete overview of managed care organizations Covers contract law basics Presents material that can be used internationally Discusses Medicaid Managed Care Offers an operational evaluation of a typical managed care agreement Includes sample contracts and important checklists, as well as a glossary