Legal Risks When Entering Into and Working Under a Health Care Contract, Research Paper Example

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Research Paper

A contractual relationship is fast becoming the popular way to manage healthcare; it’s estimated that within the next 10 years, 70 percent of all healthcare will be managed under contractual relationships. (Gale Group, 1992) All types of healthcare providers including clinics, universities, health maintenance organizations, individual practitioner organizations, preferred provider organizations pre·ferred provider organization
n.
Abbr. PPO A medical insurance plan in which members receive more coverage if they choose health care providers approved by or affiliated with the plan. , and corporate health plans enter into contractual relationships with patients. (Gale Group, 1992) But entering into and working under this type of contract is not without legal risks.

The other party’s or parties’ business history needs to be known. One runs the risk of being implicated along with a partied business if it is not up to date on certifications and licenses, for example. If a partied business fails financially, one could be held liable for the failed company’s unpaid bills if the contract is not outlined to define who is responsible. (Fisher, 2011) So financial history and viability of all parties involved in the contractual relationship is one risk to be considered.

Quality control and customer satisfaction are other areas put at risk during a contractual relationship. Credentialing processes need to be clearly outlined so there are no misunderstandings and what process will be followed in the event a physician , hospital or other care providing institution is found to have poor performance need to be clear. This is as important for customer satisfaction as it is for the protection of the contractual party. Providing for customer satisfaction should include a satisfactory way for the customer to voice any complaints or concerns about their care or the institution’s performance. When customers feel they are heard and their problems will be handled, they are less likely to seek outside legal assistance for issues. (Gale Group, 1992)

References

Fisher, D. M. (2011). Managed care is really managed financial risk. Retrieved August 7, 2012, from National Empowerment Center : http://www.power2u.org/articles/managed/fin_risk.html

Gale Group. (1992, Nov 1). Important points in managed care contracts. Retrieved Aug. 7, 2012, from  The Free Library by Farlex: http://www.thefreelibrary.com/Important+points+in+managed+care+contracts.-a013036307

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