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Collaboration between provides and managed care payers has the potential to reduce cost, improve processes, and enhance patient care. But a gulf between the two groups does the reverse-it leads to more expense and inefficiency in healthcare.
Written by Emad Rizk, MD, president of McKesson Healthcare Solutions, The New Era of Healthcare: Practical Strategies for Providers and Payers focuses on methods to force a partnership between the two groups. Through practical examples, Rizk illustrates actionable strategies to achieve alignment of clinical, administrative, and economic areas in which more efficient, cost-effective care is provided to the patient.
This book will enable readers to:
Develop physician buy-in with input from the doctor
Affect healthcare at the local and regional level, where the majority of care in this country originates
Establish patient portals that allow for information sharing between payers and providers across a computer network
Create incentive based payment programs that engage rather than physicians.
Fund electronic health records that provide access to the patient, physician and health plan
Streamline administrative processes, allowing for electronic claims submissions
Chapter 1: Why Payers and Providers Are Disconnected
Chapter 2: What Is Needed: Three Types of Alignment
Chapter 3: Getting Started: Creating a Pilot Project
Chapter 4: Tools to Support Collaboration
Chapter 5: Leading a Successful Partnership
Chapter 6: Clinical Processes for Greater Cooperation
Chapter 7: Economic Alignment: The Right Incentives
Chapter 8: Achieving Administrative Alignment
Chapter 9: A Model for Care in Pennsylvania
Chapter 10: The Future for Payers and Providers