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 Accretive Health 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
About the author:
Emad Rizk, MD is the President and CEO of Accretive Health, a healthcare company that manages end to end revenue cycle management of hospital systems. Prior to his position with Accretive Health, he was the President of McKesson Health Solutions, a healthcare services and information technology company dedicated to helping its customers deliver high-quality healthcare by reducing costs, streamlining processes, and improving the quality and safety of patient care. Rizk has a unique and in depth knowledge of the healthcare ecosystem on both a strategic and operational level. He understands the business models and interdependencies of Payer, Providers, Government, and Pharmaceutical/Biotechnology organizations. He has developed and lead strategies for change with Deloitte, McKesson, and now Accretive Health.
Published: March 2009