Archive for 'Payers'
Accountable Care Organizations (ACO’S)
19 August 2010The concept of Accountable Care Organizations (ACO’s) was given a prominent place in this year’s reform legislation. In essence, an ACO is a network of healthcare providers that manage the full continuum of care for all patients within the provider network.
The goal of an ACO is to reduce costs and improve quality [...]
Healthcare Payment Reform
24 July 2008 In many ways, the nation’s current healthcare payment system creates inefficiencies by adding cost and complexity to healthcare administration. Achieving payment system reforms will require a level of cooperation among all stakeholders.
In the current volume-based payment system physicians and others who provide high-quality, efficient care and thereby reduce the volume of patient services, [...]
Credentialing – To Delegate or Not To Delegate
5 May 2008The National Committee for Quality Assurance (NCQA) sets the standard for credentialing in managed care. Defined as the “process by which a managed care organization (MCO) authorizes, contracts with, or employs practitioners who are licensed to practice independently to provide services to its members”, credentialing simply means making sure that a practitioner is qualified [...]
The Doctor Will See You Now – Online!
1 April 2008 If you could have the equivalent of a doctor’s appointment – via the Web – without actually going to the doctor, would you do it? Would you be willing to pay for it?
Some doctors and health insurers are betting that patients will hand over a co-pay or more for the convenience of describing [...]
