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LP5.4 Assignment: Negotiating Contract Complete the assignment beginning page 492 titled “Exercise: Negotiating a Managed Care Contract” in two page paper. Submit the assignment to your instructor....

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LP5.4 Assignment: Negotiating Contract

Complete the assignment beginning page 492 titled “Exercise: Negotiating a Managed Care Contract” in two page paper. Submit the assignment to your instructor.

One of Marcus Welby Hospital 's (MWH) competitors established a successful IPA-model HMO two years ago. Fearing loss of patients, MWH is forming the Marcus Welby Managed Care Network (the Network). The objective is to sign up a number of physicians, mainly in primary care but also in common specialties, and then to market this network to these two sources: (1) large employers who provide health insurance to their workers on a self-insured basis; and (2) large regional or national insurance companies (such as Blue Cross) who then offer the network to their customers.

The Network is approaching each physician group individually and asking them to sign up nonexclusively, leaving them free to sign up with other networks or HMOs. The contract excerpts on pages 493 and following contain some common sticking points in these negotiations. Read each pairing of contract options and determine what is at stake. Then, assume the position of lawyer/negotiator for either (a) the Network or (b) a physician group who wants to sign up but is concerned about the details.

• Write in your paper what you would say in a meeting with a representative from the other side and
• Describe how you would hammer out a deal, either adopting one version or the other, or making any changes you want.
• You must therefore be able to write clearly about what the concerns of the other side would be.
• Cite when appropriate.

All reference and citation must be completed on APA style format

Answered Same Day Dec 25, 2021

Solution

David answered on Dec 25 2021
135 Votes
1

Being a negotiator for the physician group, I would like to have the details regarding the
given contract and its excerpts so that there is no hidden condition or disadvantage of being
associated with the given network. In the meeting with the representative from the network,
the future status of the negotiations and the benefits related to it would be asked so that final
decision of signing the contract with the network is done on the basis of the cost and benefit
analysis. Information regarding the overall cost of joining the network and if there is any
increment in the cost of using the equipment after a certain period of time. The representative
would like to know minimum number of years to be a part of the network and how much
value oriented will be the group, if joined. Also, the percentage of division of the received
professional fees among the hospital and the physician need to be clear beforehand.
The conditions to be fulfilled by the physician under he once joined the group would like to
leave it at some later stage. The fees or charges to be paid at that time of leaving the network
or the loss of benefit for the physicians in case it is no more beneficial for the network should
e mentioned in the deal. The difference of the deal and extra perks and benefits which are
eceived by the physicians by not becoming the part of the other big insurance...
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