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You are here > Home > Reading Lists > Finance & Accounting > Calculated Risk

Calculated Risk: A Provider's Guide to Assessing and Controlling the Financial Risk of Managed Care
Bruce S. Pyenson

Softcover: 80 pages
ISBN 0787956341
AHA Press / Jossey-Bass
August 2000
Price: $43.00

 

Calculated Risk will help providers develop risk management strategies that concentrate on the provider's financial risk as it relates to payment for health care, including:

  • applying actuarial models,
  • analyzing risk
  • implementing risk management
  • controlling and allocating variable costs, and 
  • controlling and allocating fixed costs.

Recommended by the American Hospital Association, this book provides strategies and tools for analyzing current business practices and developing successful risk management strategies. From one of the nation's foremost actuarial and consulting firms, learn how to apply field-tested actuarial cost models to assess the risks when choosing from among various strategic options - from holding a limited role as a contract partner in a provider network to being the owner/operator of a provider/insurer organization.

"This first edition book, with contributors from the national actuarial and consulting firm of Milliman and Robertson, outlines the types of managed care risks a healthcare provider must measure, evaluate, and control in the move to the nontraditional reimbursement environment of today. Its six chapters meet the objectives of demonstrating that successful risk management involves using cost models to analyze the magnitude of reimbursement proposals, managing how care is delivered, analyzing risk management strategies along a complete network continuum, using tools to manage risk sharing arrangements, and incorporating all levels of care givers in the establishment of cost-effective protocols. 

"This book serves as a useful reference for health care provider executives, risk managers, and contract negotiators who are currently engulfed in the emerging practice of shifting risk from payers to providers. The contributors, who are experts in the field of risk management, focus their discussion on risk management points pertinent to managed care negotiations and related organizational structures and strategies. As a result, the contributors are able to relay their message in an easily understandable manner... The well organized and concise approach used by the contributors makes this book a handy reference for professionals interested in assessing and controlling that managed care risk." - Jean M. Voight, CPA, BBA (Froedtert Memorial Lutheran Hospital), Doody Review, Three Stars

The American Hospital Association (AHA) is the national organization that represents and serves all types of hospitals, health care networks, and their patients and communities. Close to 5,000 hospitals, health care systems, networks, other providers of care and 37,000 individual members come together to form the AHA. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. The Health Forum was created in the fall of 1998 through the union of The Healthcare Forum and the American Hospital Association's publishing and data and information subsidiaries.

This book is recommended by the American Hospital Association.

(information provided by the publisher)

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