|
 |
Employers and Employer
Coalitions
-
Provider Network development including selection and
credentialing of high performance physician by specialty
- Direct
contracting with physicians and hospitals on a performance basis
- Purchasing coalition startup
- Vendor
evaluation to determine high cost populations within the overall
insured population as part of a program to begin to actually
predict care costs and expenses
- Medical management review
- HMO evaluation and management of open enrollment activities
- PPO Consolidation and selection process
- Design of performance based HMO contracts
- Design
and development of disease state carveout contracts with
physicians
- Primary care case management system design and
implementation
- Evaluation of PHO/Integrated care systems proposals
-
Evaluation of long term care and retiree health plans in view of
PACE and Medicare Advantage for part D options
-
Medical Management evaluation including Physician driven
guideline development, Report card benchmarking and performance
reporting, Quality system design and error reduction programs
for physicians and hospitals to improve the clinical product.
- Design and implementation of PHYSICIAN DRIVEN INTEGRATION
-
Evaluation of current claims payment and coordination of benefit
procedures to determine the most desirable providers to work
with patients.
|
 |
|
