Take Your Corners – Hospital Health Plan Negotiation Strategies

Hospital managed care teams need to understand their markets are much more expansive than other hospital competition, advises, a senior exec with a company that provides a range of services to providers.

“Essentially, there are three basic ways of dealing with negotiation differences: Continue reading

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Physicians Need To Adapt and Develop A Vision For the Future, IPA-PHO Survey Finds

The resurgence of hospitals buying physician practices, the shortage of primary care physicians, contract and reimbursement models, market consolidation and the pressure to transform primary care practices are among the key issues the leadership of the nation’s physician organizations – PHOs and IPAs are keenly concerned about.

The issues emerged from the results of the IPA -PHO Physician Organization Leadership Survey 2012 by the Managed Care Information Center (MCIC.) Continue reading

Bundled Payments May Be Another Developing Trend to Watch: Anthem Adopts Bundled Payment Agreements For Two Providers

Anthem BCBS has entered into “bundled payment” arrangements for select surgical procedures at the Orthopedic & Sports Institute of the Fox Valley in Appleton, Wis. and at Manitowoc Surgery Center in Manitowoc, Wis.

A “bundled payment” groups and coordinates all of the charges associated with a surgery and recovery together for one pre-negotiated price. This means an individual can quickly and easily understand their potential out-of-pocket costs before surgery and results in greatly reduced paperwork for all involved.

“Think of a bundled payment like a restaurant offering a complete meal for $20 deal,” said John Foley, regional Continue reading