Part 1 of this article discussed the career paths of managed-caremedical directors in both HMOs and provider organizations anddescribed their work in the area of utilization management.In this second part, we resume the description of the work ofmedical directors.
Top-level medical directors spend a substantial proportion oftheir time on quality improvement. This activity has grown inimportance as a result of the rise to prominence of the NationalCommittee for Quality Assurance (NCQA) and its Health Plan EmployerData and Information Set (HEDIS). Many HMOs seek NCQA accreditationand strive to score high on the . . . [Full Text of this Article]
Budgeting
Creating and Maintaining the Network
Evaluating Physicians' Performance
Paying Physicians
Working with Customers and Regulators
Putting Out Fires
Policy Decisions
How Are Medical Directors Paid?
Two Views of Medical Directors
Conclusions
References
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