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Abstract:
The rather abrupt introduction of payors to hospitals and vice versa that started a few years ago has now settled down into a learning situation. To be price competitive in the health insurance marketplace, the payor must obtain full contractual performance in price, administrative and utilization review areas. Hospitals need the patients that payors can refer, but there is only a minimal understanding of how the health insurance industry operates both internally and in the marketplace. By selecting payors and soliciting those selected, hospitals have an excellent chance to accomplish their patient and revenue goals while payors have the opportunity to determine the effectiveness of their various programs to help meet their goals. By making a little effort, hospitals can accomplish a lot by adding this new "P" to their marketing mix.