Managed care and revenue in single-specialty groups

Which specialties' single-specialty groups depend most heavily on HMOs for their revenue? According to the Medical Group Management Association, it's not necessarily the primary care fields ostensibly prized in managed care for their "gatekeeping" role. In two sets of data — one gathered for a survey and the other culled from the association's membership information — pediatrics and obstetrics/gynecology each attributed a higher proportion of revenue to at-risk managed care than family practice or internal medicine (though these gatekeeper specialties showed higher percentages, in turn, than such fields as cardiology, ophthalmology and orthopedic surgery). One explanation offered by MGMA: Many family physicians and internists do their gatekeeping within multispecialty organizations, so they don't show up in single-specialty group data.


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HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

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Managed Care
By Peter Wehrwein
Managed Care
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