With pharmacy costs rising nationally 8% to 15% annually and the cost of injectables rising at an even higher 15% to 25% clip, HealthCare Partners is looking for ways to improve its injectables authorization process, develop a more effective evaluation method for its therapeutic guidelines, and better integrate its utilization management information system with billing.
A growing number of capitated groups are trying to increase revenue and patient satisfaction by reducing appointment backlogs through an approach called "open" or "advanced" access. See how at risk provider groups are reconfiguring their offices and boosting their performance.
Why do provider-sponsored health plans have 20% lower administrative expenses than Blue Cross commercial plans? Here's some detailed data that you can use to benchmark your own administrative costs.
Messenger-model IPAs have a roadmap they can follow to determine whether they are sufficiently clinically integrated to avoid antitrust problems when they collectively negotiate non-risk contracts for participating physicians. Here's how.
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