Survey Results Define CMO Responsibilities

Health reform puts healthcare organizations at more financial risk than ever for care costs and quality, both inside and outside their workplace. But it doesn't change the fundamental fact that physicians, even employed physicians, remain the final arbiters of what care actually is provided. CMO responsibilities evolve with need and business acumen grows as a vital need.

By | 2017-04-19T17:20:54+00:00 April 10th, 2017|Training|0 Comments

Stretching Medical Directors Too Far?

As healthcare continues to change, so do some of the roles within the industry, but no role has perhaps experienced a shift quite as significant as the Medical Director.  This position has taken on a dramatic evolutionary shift in responsibility and scope. The roles and responsibilities now require stretching medical director skills into contract negotiations, group dynamics, organizational development, team management, and many areas not covered in a traditional medical curricula.

By | 2017-04-05T11:40:03+00:00 February 20th, 2017|Training, Uncategorized|0 Comments

Managed Care Trends | Where Are We Headed?

Many people who talk about managed care don’t realize that it has actually been undergoing a bit of a renaissance since the late 1980s - and has existed conceptually since the ‘30s. Since the late ‘80s, MCOs have progressed through several phases: Phase 1: Using utilization review and pre-admission certification to manage access to care. Phase 2: The addition of fee-for-service networks and managing benefits. Phase 3: Shift from utilization review to utilization management with an emphasis on the ‘appropriateness’ of care as well as the care setting. Phase 4: The current phase of MCO development, which has only started in the last couple of years, looks at establishing a continuum of services, lessening the tendency for providers to operate in ‘silos’ which has been the dominant structure of healthcare in the U.S. for years.

By | 2017-04-02T13:28:32+00:00 September 2nd, 2014|Accountable Care Organizations, Health Insurance, Managed Care|Comments Off on Managed Care Trends | Where Are We Headed?

Managed Care Organizations and Data Based Management

managed care organization

Managing With Data in Managed Care Organizations

In the increasingly complex world of healthcare, data based management is becoming […]

Are ACOs The New HMOs?

Historically, HMOs are notorious for incurring poor health among patients and bolstering already bloated administrative costs. When healthcare reform was on the horizon, the promise of Accountable Care Organizations in lieu of traditional HMOs lifted the wilted spirits of doctors and patients alike. A few years of ACOs, however, seems to have done little to assuage the initial fears of these groups that ACOs are just nicely dressed HMOs.

What You Need to Know About Medicaid, the ACA, and the Exchanges

How will Medicaid work with the new exchange? What changes have occurred as a result of the ACA?

Managed Care Sweeping the Nation:
Top 10 Managed Care Organizations

Currently states are making the transition to Managed Care, or allowing Managed Care Organizations to take the lead in providing healthcare to Medicaid.

By | 2017-04-14T17:02:54+00:00 January 1st, 2013|Health Care Reform, Health Insurance|Comments Off on Managed Care Sweeping the Nation:
Top 10 Managed Care Organizations

Pin It on Pinterest