Book Description

The New Era of Healthcare: Practical Strategies for Providers and Payers Emad Rizk, MD Increased collaboration between providers and payers has the potential to reduce costs, 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. The New Era of Healthcare: Practical Strategies for Providers and Payers focuses on methods to forge a partnership between the two groups. This book contains actionable strategies to develop a relationship of mutual understanding between payers and providers. The result is an alignment of clinical, administrative, and economic areas in which more efficient, cost-effective care is provided to the patient. Case studies demonstrate how the payer/provider relationship can actually benefit both sides. For example, in Mississippi, a Medicare program successfully signed up 40% of primary care physicians by clearly explaining the program that targeted at-risk poor, rural patients. Face-to-face group meetings helped win physician support, and with physicians on board, patients were more apt to take part in the program. Dr. Emad Rizk of McKesson Health Solutions provides practical examples to illustrate successful working relationships between payers and providers. This book will help enable readers to: Develop physician buy-in Impact healthcare at the local and regional level, where the majority of care in this country originates Establish portals that allow for information sharing between payers and providers Create incentive-based payment programs that engage rather than penalize physicians Fund electronic health records that provide access for the patient, physician, and health plan Streamline administrative processes and allowing for electronic claims processing The New Era of Healthcare: Practical Strategies for Providers and Payers is ideal for those employed by health plans, disease management providers, and physician practices, which are looking for cutting edge strategies that result in better outcomes, lower costs, and enhanced patient care. The strategies outlined in this book will benefit executives who have the ability to affect change in their organization. Take a look at the table of contents: 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