Hospitals & Providers Strategy
A joint collaboration between a small hospital in Indiana and an Indianapolis-based picture archiving and communications systems (PACS) and complete radiology provider enabled the small hospital round-the-clock access to radiologist services. Upon its opening in October 2006, the Monroe Hospital in Bloomington, Ind., joined forces with the PACS and radiology provider to supply the facility with radiologists to cover all of the hospital's general and subspecialty radiology services through both on-site and remote radiologists.
Virtually everyone agrees that properly incentivizing physicians—particularly rewarding the high-level performers—is critical to changing the direction of the U.S. healthcare industry. No single stakeholder can effect much of a change alone, however; if the industry is going to change, it will be with help from every direction and demographic.
The primary cost to patients with hospital-acquired infections is a prolonged stay and additional therapeutic interventions. But because of the high financial costs, there is increasing outside pressure to decrease infection rates.
The administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) require the Department of Health and Human Services (HHS) to establish national standards for electronic healthcare transactions. This includes assigning healthcare providers a National Provider Identifier (NPI), a 10-digit numeric provider identifier that will be used in standard electronic transactions, such as healthcare claims. As of a legislated date of May 23, 2007, each participating provider will have one and only one NPI, regardless of practice locations or settings.
Fundamental Enablers: Optima Health President Michael M. Dudley says not-for-profits compete on historical strengths of quality, local engagement
As the managed care industry continues to consolidate, not-for-profit and provider-sponsored plans haven't lost their niche in the marketplace. They compete on demonstrated quality and the added value of community accessibility, which would, on the surface, seem to be exactly what politicians and healthcare advocates are begging for.
It would seem that any healthcare entity able to introduce lower costs and greater convenience would be welcomed with open arms, if not a genuine ticker-tape parade. Yet, walk-in retail clinics, new players built on low cost and convenience, are struggling to gain a national foothold, and experts aren't sure the new guy will even make it in the end.
Just like the rest of healthcare, dental and vision ancillary benefit providers are adopting cost-sharing strategies that offer options to employees but demand more skin in the game. With less financial responsibility on the shoulders of employers, ancillary benefits have become more flexible, varied and are more closely tied to the overall health of individuals, who are assuming more risk for their health.