Implications,
Typically when we talk about quality management is a combination of providing good services and controlling cost. The method of many payers to manage expenses is by denying or limiting services versus managing the structure of the health plan. Unfortunately, they seem to be more vested in the business of denial management.
Conclusions,
The responsibility of quality improvement resides in all of members of the team. A unite effort from payers and providers using all resources responsibly could open the door to great quality services with controlled costs. Providers need to be aware of their recommendations based on the patient’s condition and payers need to be responsive to the medical needs of the patient.
Applications,
Our
Typically when we talk about quality management is a combination of providing good services and controlling cost. The method of many payers to manage expenses is by denying or limiting services versus managing the structure of the health plan. Unfortunately, they seem to be more vested in the business of denial management.
Conclusions,
The responsibility of quality improvement resides in all of members of the team. A unite effort from payers and providers using all resources responsibly could open the door to great quality services with controlled costs. Providers need to be aware of their recommendations based on the patient’s condition and payers need to be responsive to the medical needs of the patient.
Applications,
Our