Menu of Disease Management Related Services:
- Financial Modeling
- IPA Development
- Vascular Access Database
- Payor Contracting
- Network Development
- Consulting Projects Tailored to Your Needs
- Physician/Hospital Organization
- Renal Case Management
- Provider Contracting
- Ongoing Network Management
Integrated Delivery Network
The purpose of an integrated delivery network is to provide a vehicle upon which the various services required by patients suffering from End Stage Renal Disease (ESRD) can be “bundled” and offered to health care plans under an “at risk” payment methodology. By bundling such services as nephrology, outpatient dialysis, outpatient laboratory, and home infusion, an environment is created where all providers share incentives. Clinical outcomes are maximized at the lowest cost and problems are identified and managed early to prevent unnecessary use of high-cost clinical services. The nephrologist is responsible for the coordination of the entire spectrum of renal related services. Therefore, this concept provides a unique alternative to contracting for the magnitude of provider services required by the ESRD patient. The guiding principles are based on:
- Complete integration of financial, clinical, and operational components of ESRD care;
- Accountability for financial and clinical outcomes, including customer satisfaction within a continuous quality improvement context;
- Coordination of care across the entire continuum of illness;
- Identification of key providers who are experience rated and willing to share the risk for managing care under a fixed payment arrangement;
- Definition of expected patient care outcomes objectively measured;
- Definition of practice guidelines and protocols that best demonstrate practice parameters that enable the achievement of expected outcomes;
- Definition and implementation of a format which applies managed care principles, and nursing case management to the delivery of care to the ESRD patient; and implementation of resource utilization controls to contain cost.
The network, therefore, is responsible for the administrative expertise, organizational structure, resources, data management systems, and corporate culture necessary to identify, integrate, and manage clinical outcomes and customer satisfaction.