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Negotiating an innovative uniform infusion therapy fee: a managed care case study.
1Resource Group, Ltd., Dallas, USA.
Journal of Health Care Finance
|September 12, 2003
Summary
A new uniform infusion therapy fee model benefits health plan members, providers, and the plan by standardizing payments across care sites and separating drug delivery costs. This innovative approach requires coordinated decision-making and a dedicated project champion for successful implementation.
Area of Science:
- Healthcare Administration
- Health Economics
- Health Services Research
Background:
- Traditional infusion therapy reimbursement models can be complex and vary significantly by site of care.
- Lack of standardization in infusion therapy fees can lead to administrative burdens and financial inefficiencies for health plans and providers.
Purpose of the Study:
- To describe the development and implementation of an innovative uniform infusion therapy fee structure.
- To evaluate the success of this model from the perspectives of plan members, providers, and the health plan.
Main Methods:
- A case study approach was used to detail the conceptual and operational decision-making processes.
- Implementation involved coordinated decision-making across affected departments and the appointment of a project champion.
Main Results:
- The uniform infusion therapy fee model was successfully implemented.
- The model demonstrated positive outcomes for health plan members, providers, and the health plan itself.
Conclusions:
- A uniform infusion therapy fee, separating drug delivery costs, offers a successful and efficient reimbursement strategy.
- Successful implementation hinges on interdepartmental coordination and strong project leadership.