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Building a successful IPA

If the complement of physicians is structured appropriately and the right combination of financial stability, physician leadership and management skills are present, an IPA can be an effective model for physicians and physician practices to better serve their patients and successfully work with the third-party payors in their community, and with vendors.

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OIG approves hospital-physician gainsharing

Gainsharing's surprise recovery came in the form of an Advisory Opinion issued by the OIG. Although the OIG reiterated its concerns regarding the potential adverse affects of gainsharing on patient care and its potential for disguising payments for referrals, it permitted the hospital and physicians to enter into the carefully structured cost-sharing arrangement proposed by the requestors.

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Managed care credentialing of physicians

The credentialing process should be designed to aid an MCO in choosing competent providers and to ensure providers a fair application of the selection criteria. An MCO that exercises reasonable care in credentialing and monitoring its providers reduces its risk of malpractice liability.

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Legal obstacles to tort reform in Pa.

The medical professional liability crisis, with its spiraling liability insurance costs and exorbitant jury verdicts, has sparked a renewed and vigorous effort to demand legislative action on tort reform. In Pennsylvania there have been and continue to be obstacles to the enactment of tort reform. The law in Pennsylvania presently provides little guidance and wide latitude to juries in determining damage awards.

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