Health Provider Networks, Quality and Costs

Serviceflow Management for Health Provider Networks

Exploding expenditure in health care has led to new reimbursement regulations forcing health care providers to conduct their organisations as business concerns. In order to be competitive providers have started to build networks that allow the delivery of interrelated health services in a well-adjusted and uniform manner. However, besides strategic agreement, successful networking requires the ...

Controlling health costs and improving health care quality for retirees.

Equilibrium Provider Networks: Bargaining and Exclusion in Health Care Markets∗

Why do insurers choose to exclude medical providers, and when would this be socially desirable? We examine network design from the perspective of a profit maximizing insurer and a social planner in order to evaluate the effects of narrow networks and restrictions on their use—a form of quality regulation. An insurer may wish to exclude hospitals in order to steer patients to less expensive prov...

Many Routes to the Top: Efforts to Improve Care Quality, Coordination, and Costs Through Provider Collaborations

In response to the federal Patient Protection and Affordable Care Act of 2010 (ACA) and a combination of broader market forces, hospitals, physicians, and other health care providers around the country have been increasingly collaborating among themselves and with public and private payers on efforts to reform care delivery systems and payment methods. While their structures vary widely, most o...

Industrialization in Iran: Health Provider or Health Remover?

Despite the importance of interaction between industrialization and health, this subject has not been studied sufficiently in Iran. In this regard, the aim of this study is investigating the impact of industrialization on health in Iranian provinces during 2009-13. The used data has been collected from the Statistical Centre of Iran and the National Organization for Civil Registration. The intr...