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Swot Analysis For Healthcare

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PCPI - Physician Consortium for Performance Improvement
It is a group linked to American Medical Association which is oriented to improve the quality, safety and value of care to the patients. PCPI programs include the measurement science, improvement of the quality of care with the help of National Quality Registry Network (NQRN). [1]

NQF – National quality forum
A not-for-profit, nonpartisan, membership based organization based for improvements in healthcare. It convenes groups in public as well as private settings to improve the quality of healthcare by implementing a national strategic plan for healthcare quality measurement and reporting. This forum makes quality performance information publicly available with timely feedback and ensures …show more content…

[8]
IPA – Independent practice association
Independent practice association is legal association organized by the physicians in private practice which negotiates with the insurance companies on behalf of those private practicing physicians. [9]
EPO - Exclusive Provider Organization
Exclusive Provider Organization is a group of individual practitioners or group practitioners who negotiate with the insurance companies and reach a written agreement implying that the insurance companies provides health insurance to the subscribers enrolled under different plans. This organization also negotiates with the medical care providers and the insurance companies regarding the implementation of fee scheduling and solving any altercations among them. [10]
COB - Coordination of Benefits
Coordination of benefits is a method where payer can determine the order of the payments when he/ she is covered under multiple health insurance programs. Also, payer has advantages of faster claims, and with minimized out of pockets by choosing which plan to cover for different procedures. [11]
ACO - Accountable Care …show more content…

Medicare Part A covers the services provided under skilled nursing facilities. [16]
ASC – Ambulatory Surgical Center
Surgical center that provides services on the same day or performs outpatient surgical procedures but doesn’t offer any emergency services and these procedures are done outside a hospital setting. This new model of health care delivery provides effective treatment needs in a right time as the scheduling of procedures are at ease when compared to hospital settings requiring more time. [17]
HIPAA- Health Insurance Portability and Accountability Act
Federal law which is designed to protect the patient information by providing the privacy as well as the security of patient’s medical records when the records are provided to different hospitals, physicians. [12]
BA - Business Associate
Business Associate is an employer who works on behalf of the covered entity where the person organizes the negotiations, arrangements, assistances involved in the health information and administrative activities. [12]
CMPs - Civil Monetary

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