Health benefit plan and associated provider network design are foundational to meeting plan sponsor objectives. Here are two key health plan and network design considerations for employers and payers/administrators as they shift to increasingly value based and consumer directed healthcare plans for their employees and members. Let’s define “value” as the buyer’s definition of performance
Traditional health plan designs and operational approaches created to reimburse network providers at varying negotiated levels based on activity are no longer sufficient and may soon be outmoded. They are evolving to accommodate new value based concepts of what it means to perform and provide value to plan sponsors, employees, and their plan administrators. Read
Specialty drug management programs are complex by nature with disparate multiple stakeholders. Increasing availability and cost of specialty drugs create an unsustainable financial burden for payers. How do you most effectively integrate and manage the many detailed program components, organizations, and tactics? Combining your core strategies that you previously implemented from our Combat Specialty Drug
As a service to our healthcare industry readers and clients, Arlington Healthcare Group constantly curates and shares valuable content from a variety of sources. John Shire is an attorney and Partner with Fox Rothschild LLP. He is a recognized expert on legal issues relating to the healthcare industry. In this article from the ACO Compliance
Medical tourism is actually a relatively minor subset of medical travel – where patients travel out of their local market for medical care in search of some combination of lower price, higher quality, faster access, and access to locally unavailable treatments or clinical technology. Medical tourism/travel can be either international between countries or domestic within