Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Managed Care Insurer Medical Directors A Recruiting Opportunity for Provider Organizations That Are Taking Insurance Risk
Wednesday, January 22, 2014
The investigative Disease Management Care Blog went dumpster diving outside the headquarters of a large health care organization and found this document:
MEMO
To: The Health System CEO
From: The Front Line Docs
Re: Physician "Accountability" Leadership
Thank you for taking the time out of your busy schedule to meet with the medical staff last night. Since you arrived here a year ago, we physicians have been looking forward to our quarterly meetings and appreciate that you were able to make it this time. Thank you also for arranging the hospital cafeteria to supply the sandwiches. They and the boxed raisins were delicious!
"The white coats," as you er to us, are very interested in your vision of the insurer-contracting opportunities around efficiency, cost reductions, "accountability" and "shared savings." Like you, we are also concerned about unnecessary health care "waste" and "variation," and endorse your call to action, or rather inaction. The health insurers statististics that were reproduced in your presentation on the frequency of surgical procedures at our institution was very eye-opening. As a result, weve already started to let our patients know that, when a trip to the operating room cannot be justified, well do everything we can to achieve maximum cost-effectiveness with alternative evidence-based care pathways.
In light of the above, may I recommend that you strongly consider hiring a physician-leader with the skill-set necessary to spearhead these program initiatives. While the current Vice-President for Medical Affairs has many of the fine qualities weve come to expect of your hand-picked appointees, lets face it: he wouldnt know a PMPM if he personally passed one into a bedpan.
In my opinion, attributes of a such a physician leader should include:
1. A strong grasp of clinical and health economic outcomes, trending and statistical analysis.
2. A fundamental understanding of health insurance contracting.
3. A track record of interacting constructively with physicians, hospital administrators and community organizations. In particular, he or should she be adept at handling many of the hostile questions you faced last night. That way, you can "outsource" the anger management.
4. An ongoing commitment to patient care, including taking "call" with the rest of us.
I would like to point out that such physicians can be found among the Medical Directors that work in many of the nations commercial health insurers. While every commercial insurance plan has a senior-level ("Vice President") medical director, each if these executives usually has several medical directors reporting to him or her. Since these individuals work in very hierarchical organizations with little chance of advancement, many would jump at the chance to deploy their skills in a risk-bearing provider organization like ours. An enterprising head-hunter recruiter should have little trouble poaching some of these highly skilled docs who possess precisely the kind of talent we need.
Once again, thank you for your time and I look forward to working with you in the future.
Sincerely yours,
(illegible)
There was a also hand written note appended at the bottom:
By the way, Ive booked the MRI you requested and set up the appointment with the specialist. As we discussed, better safe than sorry!
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MEMO
To: The Health System CEO
From: The Front Line Docs
Re: Physician "Accountability" Leadership
Thank you for taking the time out of your busy schedule to meet with the medical staff last night. Since you arrived here a year ago, we physicians have been looking forward to our quarterly meetings and appreciate that you were able to make it this time. Thank you also for arranging the hospital cafeteria to supply the sandwiches. They and the boxed raisins were delicious!
"The white coats," as you er to us, are very interested in your vision of the insurer-contracting opportunities around efficiency, cost reductions, "accountability" and "shared savings." Like you, we are also concerned about unnecessary health care "waste" and "variation," and endorse your call to action, or rather inaction. The health insurers statististics that were reproduced in your presentation on the frequency of surgical procedures at our institution was very eye-opening. As a result, weve already started to let our patients know that, when a trip to the operating room cannot be justified, well do everything we can to achieve maximum cost-effectiveness with alternative evidence-based care pathways.
In light of the above, may I recommend that you strongly consider hiring a physician-leader with the skill-set necessary to spearhead these program initiatives. While the current Vice-President for Medical Affairs has many of the fine qualities weve come to expect of your hand-picked appointees, lets face it: he wouldnt know a PMPM if he personally passed one into a bedpan.
In my opinion, attributes of a such a physician leader should include:
1. A strong grasp of clinical and health economic outcomes, trending and statistical analysis.
2. A fundamental understanding of health insurance contracting.
3. A track record of interacting constructively with physicians, hospital administrators and community organizations. In particular, he or should she be adept at handling many of the hostile questions you faced last night. That way, you can "outsource" the anger management.
4. An ongoing commitment to patient care, including taking "call" with the rest of us.
I would like to point out that such physicians can be found among the Medical Directors that work in many of the nations commercial health insurers. While every commercial insurance plan has a senior-level ("Vice President") medical director, each if these executives usually has several medical directors reporting to him or her. Since these individuals work in very hierarchical organizations with little chance of advancement, many would jump at the chance to deploy their skills in a risk-bearing provider organization like ours. An enterprising head-hunter recruiter should have little trouble poaching some of these highly skilled docs who possess precisely the kind of talent we need.
Once again, thank you for your time and I look forward to working with you in the future.
Sincerely yours,
(illegible)
There was a also hand written note appended at the bottom:
By the way, Ive booked the MRI you requested and set up the appointment with the specialist. As we discussed, better safe than sorry!
Affordable Health Insurance for the Unemployed
Thursday, August 22, 2013
Affordable Health Insurance for the Unemployed
If youre dismissed, you would like to seek out insurance to forestall this from happening. Elapid may be a law within which many folks may be eligible to stay on associate employers insurance set up even once they lose their employment. the foremost ideal person for this coverage is somebody UN agency is between jobs and isnt in want of impermanent facilitate. It will last a minimum of a year to people who qualify, however the premium quantity remains associate expense that some dismissed people might not be ready to beware of with their lack of financial gain. If square measure|youre} ready to pay the premium and are eligible, elapid also will cowl your partner and youngsters UN agency area unit keen about you for insurance.The most effective thanks to verify if youll receive insurance is to contact your native employers advantages department and fill out the specified forms. youll additionally go looking for typical insurance. several free web services area unit evidenced reliable by the higher Business Bureau on-line. By speaking with one in all these insurance specialists, youll get facilitate finding the foremost cheap insurance that may suit your specific desires. They recognize the rates of thousands of insurance firms and may fix you up with acceptable coverage for your specific desires. If youve got a partner or kids, having health coverage may be a necessity.
Life is packed with sudden events and you cant make sure that everybody can keep utterly healthy till youve got insurance once more as a result of accidents do happen. Finding a reasonable coverage rate on your own are often a problem. The specialists at these firms area unit giving their help to you, usually as a free service. whether or not you would like to seek out one thing short-run or for associate extended amount, theyre qualified and dedicated to serving to you.
If you discover yourself dismissed at any time in your life, youre in all probability while not insurance. This may be a nightmare whether or not youve got a family or not as a result of medical expenses can place you into debt quickly. Luckily, there area unit ways that of finding cheap coverage suppliers that may keep your health, also as your finances, safe. A straightforward doctor visit will price you considerably extra money than it might with insurance. dont let yourself become one in all the various people that area unit sadly living life while not correct amount.
Source : ArticleBiz
Why Do Health Insurance Rates Go Up
Wednesday, June 5, 2013
Why Do Health Insurance Rates Go Up?
If you listen to your own personal insurance rates, youre possible to note that over a amount of your time theyre quite possible to travel up. the general public area unit attentive to the actual fact that insurance premiums tend to extend over time, and these jumps in price will gift quite an money strain for someone UN agency is on a decent budget. so as to be able to best anticipate once your rates can go up within the future, its an honest plan to pay a while learning concerning however insurance rates area unit calculated and why they often head skyward.
Although many folks notice their insurance rates intensifying, few folks ever remark on their insurance rates happening. Premiums terribly seldom fall, and also the reason for this reality is that the same reason for many will increase in insurance rates. like all alternative field of the fashionable business world, the health care business is deeply laid low with inflation. because the price of living rises, the price of medical aid rises with it. this suggests that insurance firms area unit forced to boost their rates to avoid losing cash. Inflation is wide thought of by economists to be the first reason why insurance rates increase.
The other reason why {you area unit|youre} possibly to search out yourself paying a lot of for insurance coverage is that you just are cost accounting your insurer cash. The a lot of insurance claims you create, the more cash the corporate must pay on you. This causes you to, to some extent, a money liability, therefore if you create claims usually your company can raise your rates. thanks to this reality, identical {people UN agency|people that|folks that|those that|those who} want insurance the foremost area unit those who usually find yourself straining to form their monthly payments when a increase in their insurance rates.
To protect themselves, insurance firms typically provide higher rates to totally different folks looking on however usually those customers area unit possible to form claims. this is often why folks with chronic conditions like respiratory disease, vision issues, or polygenic disease area unit possible to possess higher rates than folks while not similar afflictions. its conjointly the explanation why those that smoke and area unit so possible to possess smoking-related health issues have higher insurance premiums than most non-smokers, UN agency area unit statistically less possible to form insurance claims. If you have got recently visited a hospital or have had a doctor write you a brand new prescription, prepare to check your insurance rates increase consequently.
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