Improve--rather than lose--your risk-taking entity
Prescott, F.M.
Healthcare Financial Management Journal of the Healthcare Financial Management Association 54(2): 39-41
2000
ISSN/ISBN: 0735-0732 PMID: 10947413 Document Number: 524146
When an HMO transfers financial risk to a provider risk-taking entity such as a physician-hospital organization (PHO), independent physician association (IPA), large medical group, or other provider contracting organization, it sometimes also transfers responsibility for administrative functions, such as claims processing. As a result, these providers risk financial problems related to medical costs, pricing, and underwriting strategies, as well as administrative efficiency. Financial managers should be aware of key indicators and processes that identify such problems to be able to take action before losses occur.