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Message board discussion on Physical Therapy issuesThis is a message board where issues related to physical therapy are discussed. This is an anonymous (no registration required), independent and unmoderated message board. Any opinions posted are the opinions of the respective authors, and are the respective authors' sole responsibility. There is no warranty of contents whatsoever.Link to the discussion board on Physical Therapy Reimbursement Issues: Discuss Physical Therapy Reimbursement | ||
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PTPN Therapy Network Selects FOTO SystemPTPN, the country's first and largest network of independent rehabilitation therapists in private practice, has announced plans to launch an unprecedented national outcomes program in 2007. PTPN selected the FOTO System to track patient progress, and all PTPN members are required to have FOTO implemented by the end of 2007. According to FOTO CEO Ben Johnston FOTO's information will be shared with the insurance industry, he states "FOTO's measurement tools provide objective evidence of functional outcomes and therefore give providers and payors the critical information they need to manage patient care by evidence, not by anecdote."PTPN Therapy Network Selects FOTO System to Track Patient Progress |
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FOTO uses data mining to determine paymentFocus On Therapeutic Outcomes, Inc., (FOTO), is a national medical rehabilitation outcomes database designed for providers, patients and payers of rehabilitation care. FOTO uses risk-adjusted data to predict the number of visits necessary and degree of benefit derived from rehabilitation. Results are tabulated and reports are benchmarked to the national database, which is privately owned, confidential and independent of all providers and payer-related organizations. The data and methodology can be used, presumably by the payers which are usually insurance companies, as the basis of a pay-for-performance system for the outpatient therapies, thus aligning the incentives in rehabilitation therapy. More concisely, FOTO's data can be used as the basis for determining payment predicated on a comparison of results of intervention to the time, cost and quality parameters revealed by the database.FOTO: Letter to the House Committee on Ways and Means |
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Webcasts on Data Mining in Healthcare UnderwritingHealthcare insurance purchasers are demanding quantifiable justification for continued premium increases, getting more interested in cost-management programs and driving insurers to produce more-accurate rates. Healthcare insurance actuaries and underwriters have recognized the need for greater precision and have begun to add predictive modeling to their arsenal of analytic tools. SAS, the largest data mining software provider in the financial industry, is offering a webcast series on predictive analytics in healthcare.SAS: Announcement of webcast series on predictive analytics in healthcare |
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The Retail Revolution in Health InsuranceThe healthcare industry is expected to transform itself much more into a retail-oriented industry, selling to customers directly. To price effectively, payers must understand not only the risk profiles of individual consumers but also their true cost to serve, which often varies by segment and channel. Marrying insights about the behavior of consumers with the methods of actuarial science could create a competitive advantage. Progressive, for example, transformed the auto insurance industry by building sophisticated actuarial models that allowed the company to gain share broadly and to play profitably in high-risk markets such as those for young drivers and motor-cyclists.The McKinsey Quarterly: The retail revolution in health insurance |
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Inefficiencies in the Healthcare Payment SystemThe system is currently highly inefficient considering all the paperwork, denials, appeals, and corrections that are the day-to-day experience of any patient, healthcare provider, and payer. The healthcare industry is expected to transform itself significantly to make payments more efficient, as for example in the financial industries. The current payers might lose influence, and the financial institutions might gain it. This is an interesting development to watch, would you want to have your bank handling your healthcare transactions?The McKinsey Quarterly: Overhauling the US health care payment system |
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