Large health care insurance plans have encouraged UW Health and Unity Point Health Meriter to integrate services to better manage utilization cost across the region. This means sharing a budget and operating jointly. This influence on the payer side is to divert new construction money toward patient care.
Large health care insurance plans have structured reimbursement to a value based approach. This challenges health care delivery to:
- demonstrate bench mark capacity for responsiveness
- safe treatment regimen with readmission reimbursement changes
- submit invoice within tighter claims time lines
- adequate reserve to participate in fiscal (reach back) analysis
- evidence for treatment and care assurance
- interventions to minimize risk across health care transitions
This is serving larger populations (Health Insurance Requirement) in a safer way with existing resources. Proper planning and coordination is an essential piece of maintaining the ability to continue to operate and serve the community.
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