| Bridge Out: A road sign you really never
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| | physician or facilities' billing rate for
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| want to see. Its appearance in your path
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| | a service is significantly different than
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| means that there has been a failure and
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| | a contracted rate. And a contracted rate
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| that you have to find a new way of
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| | or allowable charge is significantly
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| getting where you want to go. The rise of
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| | differerent than the acutal amount paid
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| consumer-driven health plans indicates
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| | for services by an insurer or other third
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| that the era of managed care failed to
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| | party payer. So healthcare consumers
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| control the increased cost and demand for
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| | will need to understand all of these to
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| care and that many things about the way
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| | be able to make the appropriate choices.
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| we receive healthcare in the US.In late
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| | Also healthcare providers will need to
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| August 2006, Wellpoint, one of the
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| | set up a system to be able to accurately
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| nation's biggest healthcare insurance
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| | inform the consumer the costs for a
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| providers, has gone on record stating
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| | service. While this seems easy enough,
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| that in 2007 they will the first insurer
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| | it becomes increasingly complex when one
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| to have consumer-driven health plans in
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| | understands that every, single, solitary
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| all states and for all types of people
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| | insurance plan is different in regards to
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| (from major employers to small groups to
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| | deductible, copay, contracted rate and
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| individual plans). "Our customers who
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| | reimbursement rate.Second, in order to be
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| choose these consumer-driven products
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| | able to chose the cheapest, effective
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| will have new opportunities to lead
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| | treatment, healthcare consumers will have
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| healthier lives because of this
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| | to know and understand their treatment
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| first-of-its-kind national offering,"
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| | options. This means that they will need
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| Wellpoint CEO, Larry GlassockThe press
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| | to better understand the science behind
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| release also goes on to share: "we're
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| | their illnesses as well as the science
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| empowering consumers through unique and
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| | behind the possible treatments. This
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| robust online tools and incentives that
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| | would be a whole lot easier if we went
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| encourage and reward them for choosing to
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| | back to the old world model of having
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| live healthier lifestyles... Consumers
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| | healthcare providers that were able to
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| who choose Lumenos will be eligible for
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| | develop rapport and a trusting
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| extensive preventive care and personal
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| | patient-provider relationship. In the
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| health coaching, as well as smoking
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| | past, providers were given the time and
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| cessation and weight management programs.
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| | opportunity to really partner with
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| In addition, most consumers will receive
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| | individuals, understand the complexities
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| financial rewards for completing various
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| | of care and develop a truly individualzed
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| wellness programs." WOW! That sounds
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| | treatment that best fit the patient
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| great, right?!?!?! Well, I always read
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| | consumer's need. However, in the days of
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| these things and think about what my
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| | the 15 minute visit, this becomes
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| parents and my in-laws know about
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| | increasingly difficult to do.President
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| healthcare/ health policy and what they
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| | Bush's recent executive order pushing for
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| would think.So for those of you who are
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| | many things including transparency of
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| not familiar with this new type of health
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| | pricing information is an attempt to
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| plan, their implementation will produce
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| | address the issue of understanding the
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| significant changes in how care is
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| | financial aspects.However, how do we make
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| reimbursed. Consumer-driven health plans
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| | sure individuals have the information
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| are designed to shift some of the
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| | they need to be able to get the best
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| financial decision-making and
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| | treatment value? In reality, physicians
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| responsibility to the individuals who
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| | and healthcare providers, because of
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| consume healthcare services. Health
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| | their ability to understand and evaluate
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| savings accounts and high deductibles are
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| | individual cases and circumstances, are
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| key components to this new type of health
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| | the best resources for helping
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| plan. The thought behind all of this is
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| | individuals make these decisions.
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| to allow patients to determine how best
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| | However, they will likely need to develop
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| to spend their healthcare dollars.If you
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| | new ways of doing this that are cost and
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| buy into traditional economic theory as
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| | time efficient. If healthcare providers
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| applicable to the healthcare industry,
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| | do not develop these new ways, consumers
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| this is not a bad way of trying to
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| | patients will be left to fend for
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| control skyrocketing costs. Since the
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| | themselves.If consumers do not adequately
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| price of services has a direct impact on
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| | educate themselves or access resources
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| demand for services, in theory , this
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| | advocates that will assist them, then
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| type of plan has the potential to reduce
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| | this plan too is doomed. Costs will not
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| duplication of services and unnecessary
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| | be contained, health will not be
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| utilization of higher levels (more
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| | preserved and access to appropriate,
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| expensive) of care. In very simple
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| | effective care will continue to be
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| terms, if patients are required to share
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| | compromised.Carol is the Vice President
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| some of the financial responsiblity of
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| | of The Promedica Research Center. She has
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| their care, then they are more likely to
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| | a masters degree from Mercer University
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| choose the cheapest, most effective
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| | in Health Policy and Administration and
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| care.There are at least two very big
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| | currently teaches a master's level course
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| 'rubs' to this plan. First, in order to
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| | on Health Care Organizations for the
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| to be able to make appropriate choices,
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| | University of Phoenix (Online), College
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| consumers will need to know the cost of
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| | of Health Sciences.
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| the care. While it seems easy enough, a
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