ipl-logo

Collaboration In Healthcare

490 Words2 Pages

In today’s ever changing healthcare environment, the only way that healthcare providers and organizations can be successful in through collaboration. With the advances in technology and the enormous amount of data available, information is fast becoming a commodity. What is important is what healthcare organizations do with the information they obtain. The information needs to be shared in order to innovate across the organization. The acquired knowledge, experience, ideas, and action items needs to be shared with colleagues, partners, suppliers, patients and other healthcare organizations in order to develop something good with the information. “A driving force behind these partnerships is the quest to expand access to data that holds …show more content…

This innovative business model will help control the flow of patients. The healthcare industry is moving towards a pay-for-performance model for reimbursement. This type of partnership is beneficial to both healthcare providers and insurers because it allows for better management of resources and dollars, they require less capital, and insurance plans can be offered quicker. Additionally, the larger insurance companies can absorb the costs of the hospital starting up a new healthcare insurance business. “Like other hospital chains across the country, it’s under intense pressure from public and private insurers, as well as employers, to accept flat-rate payments for care, rather than reimbursements for every service. And that puts pressure on hospitals not just to manage costs, but to keep people well – in short, to act more like insurers” (Rabin, 2012, p.1). A health insurance partnership between the hospital and insurance companies can improve care coordination which will result in higher levels of patient satisfaction. The goal of creating these partnerships with insurance companies is to reduce costs by encouraging healthcare providers to decrease discrepancies or differences in care through implementing evidence based practices. As an insurer, the hospital would be responsible for the cost of hospitalizations, thus not making revenue from it. However, it would compel the hospital to use more of its resources on providing preventative

Show More
Related
1109 Words | 5 Pages

This question represents at least half of the medical community, and makes people question the intended and unintended consequences in a profit - driven health care system, the supposition of quality health today, and whether they

Read More
1683 Words | 7 Pages

The Accountable Care Organizations are a coordinated effort between healthcare providers to ensure the best quality of care delivered to the patients and at the same time at a reduced cost. This means that health care providers will voluntarily come together to form the ACO and patients will be able to get treated by any provider in the organization. Apart from that, it will reward the providers for delivering quality care. Even though the ACOs is comparatively a new concept, but its certain concepts and features are closely related to early managed care organizations (Barnes et al.,2014). Both MCOs and ACOs rely on the creation of physician network, promotion of member health and resource management to control costs.

Read More
535 Words | 3 Pages

Enhanced IT that supports consumers, payers and providers via analytical tools and resources relieves financial and human capital burdens. Data collection and distribution empowers collaboration and coordination of care, regardless of where a patient receives treatment. End-to-end seamless integration connects facilitates faster registration, efficient referrals and consultations, results sharing and patient

Read More
1358 Words | 6 Pages

In the film Escape Fire the Fight to Rescue American Healthcare, there were many insightful examples of why our Unites States healthcare revolves around paying more and getting less. The system is designed to treat diseases rather than preventing them and promoting wellness. In our healthcare industry, there are many different contributors that provide and make up our system. These intermediaries include suppliers, manufacturers, consumers, patients, providers, policy and regulations. All these members have a key role in the functionality of the health care industry; however, each role has its positives and negatives.

Read More
723 Words | 3 Pages

The is a discussion of quality measures. A brief review of provider contracting is included. The is a status update of the project. A model of the Integrated Care Delivery System (ICDS) is also presented. This information is relevant to healthcare care provides as it provides information as to the state’s choice of a MCO over the ACO model.

Read More
1075 Words | 5 Pages

The evolution of managed care organizations has created a dramatic change in our health care system. In 1995, about 161 million American citizens, were enrolled into a managed care organization plan. Some of the plans under the managed care are health maintenance organizations (HMO), preferred provider organizations (PPO), point of service plans (POS), and other networks such as Exclusive Provider Organization (EPO), and union plans. All these plans are different from one another in regards to organization structure, reimbursement for providers, types of services, and care access strategies. However, the goals established by managed care are to reduce and control cost of medical and behavioral health services through case management or care

Read More
626 Words | 3 Pages

In terms of insurance, it would still be presentable towards the private-public service however an additional fee will be required to ensure a better quality of services. By initiating this idea, hospitals will start to become more efficient since they are providing more options to receive treatment and the decision will ultimately be based upon the view of the

Read More
704 Words | 3 Pages

Like HMOs, the lynchpin in the ACO will be the primary care physician. However, unlike the current system, the network of doctors and hospitals will be rewarded for keeping costs low while providing the best possible service to patients. Indeed, bonuses will be paid to members of ACOs who manage to adhere to this decree. For those hospitals and doctors who already have a favorable balance of low cost and excellent care, the ACO model should prove easy to move into and would, in fact, compliment an already existing system. For those who are not performing to the standards of this mandate, the ACO requirement will offer encouragement – prodding, even – to conform to the higher set of standards.

Read More
962 Words | 4 Pages

The incentive for a better quality of care, or the desired behaviors to receive payment, rely on patient safety and cost containment to drive higher reimbursement (Burns, Bradley & Weiner, 2012, p 257). For example, if a hospital decreased medical errors of health acquired infections (HAIs), revenue is increased but the inability to reduce HAIs decreases reimbursement (Peasah, et al., 2013). Charge-based payment are based a rate schedule set by the charge master, who is the provider. It is affected by areas with limited access to services and negatively affects self-pay or private pay patients (Gapenski, p 44). Discounted charges or bulk rate discount chares are negotiated when insurers have a large number of patients available to the

Read More
612 Words | 3 Pages

Saunier (2011) states, “The genesis of the growth of health care costs stems from the advent of the third-party payor, such as insurance companies” (p.22). The advantages of controlling costs are providing the community with readily available and quality care at prices lower than those of the for-profit organizations. Less constraints give patients more autonomy with physicians and have potential to provide more revenue to the organization. The disadvantages are equally important. Strict rules and regulations may reduce quality of care and dissuade physicians from participating with different managed care

Read More
1494 Words | 6 Pages

With the implementation of a premium support system, beneficiaries would be insured under a private insurance plan and consequently, restricted to the medical networks that accept their specific insurance. Even so, the innovations in payments and health delivery systems pioneered by Medicare has often been adopted by private insurance. One such innovation is the implementation of the prospective payment system in which the payment for the specific service is based on its classification which aims to incentivize hospitals and medical providers to “provide the necessary care in the least expensive manner.” This system was introduced as a method to reduce costs as well as to provide the optimal care for beneficiaries, which is second to profit-seeking companies. Consequently, without Medicare, such innovations to the healthcare system today would not exist - simply because there was no monetary incentive for private companies to improve quality of care for

Read More
1152 Words | 5 Pages

Introduction One of the biggest challenges in managing medical practice is managing cash flow. In theory, it seems as simple as providing a service, then collecting the payment. In reality, however, bad planning, insurance documents, high abstracted patients and lack of employee training often create collection inefficiency and cause cash flow problems. Multi-hospital system over the past 30 years, multi-hospital systems including tax exemptions and for-profit organizations have developed much faster than independent hospitals. Assume that the multi-hospital system has several advantages, including: • Better access to the capital market, thereby reducing capital costs • Eliminate repetitive services, thereby increasing the remaining site 's

Read More
1249 Words | 5 Pages

Physicians and Hospitals go hand in hand when it comes to the medical care of patients, and it is this relationship that allows the patients to receive the care they need and deserve. It is also this relationship that we as health care administrators need to understand. In order to fully understand this relationship we need to define the concept of the integrated physician model. We also need to explain the importance of clinical integration in the strategic planning process, and the dynamics of and controversies surrounding accountable care organizations and alternative approaches to the current health system. I will also explain the advantages and disadvantages for hospitals and physician’s models.

Read More
1551 Words | 7 Pages

As the healthcare landscape continues to shift, medical providers and hospitals are continuously being challenged to develop clear and concise visions and redesign care delivery in ways that will usher proper transitions to value-based care. As value-based healthcare continues to take root, more and more hospitals and providers are finding themselves with little option but to join the movement. However, the jump from previously utilized fee-for-service models to value-based healthcare is not an easy one, and many healthcare organizations are finding it difficult to do so. The greatest challenge lies in successfully making the transition from volume to value-based healthcare in ways that are financially stable. Such inherent difficulties faced by those within the healthcare system are what have necessitated strategic

Read More
503 Words | 3 Pages

Under direct contracting, providers must go beyond their traditional roles as suppliers of care to owners of integrated financing and delivery systems. This transition can be difficult for employers to compile and manage actuarial and legal mandates. A physician group can be presented as a threat to health plans, as it does business by obtaining an insurance license. This is because the subcontractor is a competitor. Providers must become active managed care partners with employers, instead of being reactive adversaries of managed care organizations on a contractual basis.

Read More

More about Collaboration In Healthcare

Related Topics

Open Document