Negotiating an innovative uniform infusion therapy fee: a managed care case study.
The medical director of this health plan established an innovative uniform infusion therapy fee whereby the plan pays a uniform infusion fee across all sites of care and contracts separately for delivery of the drug itself. The concept works successfully on three levels: (1) for plan members; (2) for plan providers; and (3) for the plan itself. This case study sets forth the conceptual and operational decisionmaking sequences involved. Establishing the innovative process required two primary elements: (1) coordinated decision making within all departments that were affected by the model; and (2) a champion to carry the project to a successful conclusion.
Baker
Judith J
JJ
Resource Group, Ltd., Dallas, USA.
D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000191:economics; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy; D003657:Decision Making; D016527:Drug Costs; D005251:Fees, Medical / Q000592:standards*; D006801:Humans; D007087:Illinois; D007262:Infusions, Intravenous / Q000191:economics*; D008329:Managed Care Programs / Q000191:economics*; D008923:Missouri; D017008:Negotiating; D019982:Organizational Case Studies; D009936:Organizational Innovation; D010824:Physicians' Offices / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic
D000911:Antibodies, Monoclonal