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CHAPTER I--Introduction
A. The Managed Care Trend
C. The Critical Importance of a Good Contract
D. Uses and Limitations of This Guide
CHAPTER II--Designing, Procuring, and Implementing a Managed Care System
Stage 1: Designing a Managed Care System
Step #2: Develop the Initial System Design
Step #3: Analyze Historical Costs and Project Future Costs of the Initial Design
Step #4: Determine Optimal Financing Mechanisms, Payment Methods, and Financial Risk Level
Step #5: Build Stakeholder Consensus
Stage 2: Procuring Managed Care Services
Step #6: Write the RFP
Step #7: Establish Fair and Legally Sound Procurement and Evaluation Procedures
Step #8: Select a Vendor, Negotiate Issues of Contention, and Award the Contract
Stage 3: Implementing a Managed Care System
Step #9: Sign, Implement, and Administer the Managed Care Contract
Step #10: After Procurement, Monitor, Audit, and Evaluate Performance Under the Managed Care Contract
CHAPTER III--Coverage
CHAPTER IV--Contracting for Network Services
CHAPTER V--The Management Information System
CHAPTER VI--Quality Management
CHAPTER VII--Financial Issues
CHAPTER VIII--Consumer Protections
Last Updated 11-7-02
