Model citizens. Outsourcing helps start-up Medicare HMO.
Health Plans of Pennsylvania (HPP), the managed care arm of Crozer-Keystone Health System, in Media, Pa.


OBJECTIVE
Selecting the information systems and building the infrastructure to support the start-up of a new Medicare HMO product.


METHODS
HPP chose to outsource the information systems needed to integrate all the components of managed care administration into a cost-effective and cohesive program.


RESULTS
Because of its aggressive programming and start-up of the MedCarePlus product offering, HPP became the first plan in the country to submit Medicare claims data electronically for encounter reporting to the Health Care Financing Administration (HCFA).


CONCLUSIONS
"Through an integrated team approach, an organization truly can benefit from the economies of scale gained through outsourcing."
Slavic
B
B
Adami
S
S
D014487:Centers for Medicare and Medicaid Services, U.S.; D006126:Group Processes; D006279:Health Maintenance Organizations / Q000191:economics / Q000458:organization & administration*; D007256:Information Systems / Q000458:organization & administration*; D007344:Insurance Claim Reporting; D020398:Medicare Part C / Q000191:economics / Q000458:organization & administration*; D020416:Outsourced Services / Q000191:economics / Q000458:organization & administration*; D015143:Philadelphia; D014481:United States