Contributors
Introduction
1. Introduction to Risk Management
2. Risk Management in Managed Care
3. The Risk Manager's Role in the Integrated Delivery System
4. Integrating Risk Management, Utilization Management, and Quality Management: Maximizing Benefit through Integration
5. Incorporating Quality Improvement Strategies and Benchmarking into Risk Management
6. Benchmarking in Risk Management
7. Risk Management Strategic Planning for a Changed Health Care Delivery System
8. Developing Tools To Identify and Manage the Risks of Managed Care
9. Setting Up a Risk Management Department
10. Understanding the Need for a Corporate Compliance Program
11. Developing a Risk Management Manual
12. Risk Management and Program Development
13. The Risk Manager's Responsibility in Off-Premises Locations
14. Managing the Data Needs of Managed Care
15. Education As a Valuable Risk Management Tool
16. Consent Issues in the Medical Environment
17. A Basic Insurance Primer
18. Understanding Provider Excess and Stop-Loss Insurance
19. Insurance Products To Minimize
the Financial Risks of Managed Care
20. Risk Financing: An Important Risk Management Function
21. Risk Financing Issues Facing Medical Providers
22. Guidelines for In-House Claims Management
23. Risk Management Issues Associated with Anesthesia
24. Developing a Comprehensive Risk Management Program in Obstetrics
25. Risk Management Issues in the Emergency Department
26. Risk Management in the Pediatric Setting
27. Risk Management in the Psychiatric Setting
28. Management Risks Associated with Clinical Research
29. Management Risks Associated with Telemedicine
30. Management the Risks of Home Health Care
31. Legal Issues Associated with the Use and Development of Practice Guidelines
32. Managing the Risks of Workers' Compensation
33. Credentialing Issues and Managed Care
34. The Physician As Gatekeeper--What Are the Risks?
35. Ethics, Accreditation, and Managed Care: A Guide for Risk Managers
36. Legislative and Regulatory Issues
37. COBRA Risks and Managed Care
38. Managed Care Contracting
Index
