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PageTuesday, October 17, 2006
In particular, insurance actuaries are fond of the episode allowance model of reimbursement for acute and chronic care. Self-directed health plans can accomplish wider variability in all premium price levels. Any physician who has ever participated in a capitated reimbursement program knows well that he or she is the only partially responsible person for surfeit utilization. Patients drive an extensive amount of the demand for health services.
The managed care model of payment, with limited co-pays, encourages excess patient demand for services. Self-directed health plans will also become dependent upon Internet-based exchanges, where as patients can quickly determine the actual price providers are willing to accept for specific services. Consumers can go online and find prices as well for any product virtually they purchase in the American economy but were only very recently empowered for viewing the negotiated payment rates for physician services.
Online exchanges are now publishing their negotiated payment rates that are obtained from networks of providers, such as PPOs, IPAs, and integrated delivery systems. Consumers will also be able to log onto these exchanges, looking up a physician in their neighborhood, resolve the lowest discounted rate available to them, and also discover a range of quality information about that physician within a few years. Patients will have an access to information about volumes, patient satisfaction, educational background, and sanctions about every health care provider and so on.
posted by renaa
@ 2:27 PM
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