Methods for collecting fees for healthcare management group
First Claim
1. A method of collecting fees for managing and optimizing the profitability of a plurality of physicians in a healthcare practice participating in an insurance network, the method comprising the steps of:
- establishing a relationship between a healthcare consultation group and the healthcare practice participating in the insurance network to increase the plurality of physicians'"'"' profitability by reducing a risk of the healthcare practice not receiving a predetermined reimbursement amount for ancillary medical costs from the insurance network;
funding an incentive pool;
gathering data in a tangible computer medium from each of the plurality of physicians in the healthcare practice participating in the insurance network including ancillary medical costs respective to the physicians;
modifying behavior of at least one of the plurality of physicians in the healthcare practice for management of the ancillary medical costs responsive to the data gathered in the tangible computer medium;
determining whether the ancillary medical costs of the plurality of physicians in the healthcare practice have reached a predetermined level within a preselected period of time;
paying funds from the funded incentive pool to the healthcare practice participating in the insurance network when the ancillary medical costs of the plurality of physicians in the healthcare practice have not decreased to the preselected level over the preselected period of time; and
distributing predetermined percentages of savings attributed to the modifying behavior of the plurality of physicians ancillary medical cost management if the ancillary medical costs of the plurality of physicians in the healthcare practice have decreased to the preselected level over the preselected period of time.
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Accused Products
Abstract
Methods are provided for collecting fees for managing and optimizing the profitability of a plurality of physicians in a healthcare practice participating in an insurance network. The methods include establishing a relationship between a healthcare consultation group and the healthcare practice participating in the insurance network to increase the physician'"'"'s profitability by reducing a risk of not receiving a predetermined reimbursement amount for ancillary medical costs from the insurance network. The methods also include distributing predetermined percentages of savings attributed to the physicians'"'"' modified ancillary medical cost management behavior.
60 Citations
19 Claims
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1. A method of collecting fees for managing and optimizing the profitability of a plurality of physicians in a healthcare practice participating in an insurance network, the method comprising the steps of:
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establishing a relationship between a healthcare consultation group and the healthcare practice participating in the insurance network to increase the plurality of physicians'"'"' profitability by reducing a risk of the healthcare practice not receiving a predetermined reimbursement amount for ancillary medical costs from the insurance network; funding an incentive pool; gathering data in a tangible computer medium from each of the plurality of physicians in the healthcare practice participating in the insurance network including ancillary medical costs respective to the physicians; modifying behavior of at least one of the plurality of physicians in the healthcare practice for management of the ancillary medical costs responsive to the data gathered in the tangible computer medium; determining whether the ancillary medical costs of the plurality of physicians in the healthcare practice have reached a predetermined level within a preselected period of time; paying funds from the funded incentive pool to the healthcare practice participating in the insurance network when the ancillary medical costs of the plurality of physicians in the healthcare practice have not decreased to the preselected level over the preselected period of time; and distributing predetermined percentages of savings attributed to the modifying behavior of the plurality of physicians ancillary medical cost management if the ancillary medical costs of the plurality of physicians in the healthcare practice have decreased to the preselected level over the preselected period of time. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method of collecting fees for managing a plurality of physicians in a healthcare practice participating in an insurance network, the method comprising the steps of:
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establishing a relationship between a healthcare consultation group and the healthcare practice participating in the insurance network to reduce a risk of the healthcare practice not receiving a predetermined reimbursement amount for ancillary medical costs from the insurance network; funding an incentive pool; establishing a plan to pay funds from the funded incentive pool to the healthcare practice participating in the insurance network, wherein the payment of funds occurs in the plan when the ancillary medical costs of the plurality of physicians in the healthcare practice do not decrease to a preselected level over a preselected period of time; gathering data in a tangible computer medium from each of the plurality of physicians in the healthcare practice participating in the insurance network including ancillary medical costs respective to the physicians; modifying behavior of at least one of the plurality of physicians in the healthcare practice for management of the ancillary medical costs responsive to the data gathered in the tangible computer medium; determining whether the ancillary medical costs of the plurality of physicians in the healthcare practice have reached the preselected level within the preselected period of time; and distributing predetermined percentages of savings attributed to the modifying ancillary medical cost management behavior of the plurality of physicians if the ancillary medical costs have decreased to the preselected level over the preselected period of time. - View Dependent Claims (9, 10, 11, 12)
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13. A method of collecting fees for managing and optimizing the profitability of an insurance network having a plurality of physicians in a healthcare practice participating therein, the method comprising the steps of:
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establishing a relationship between a healthcare management consultation group and the healthcare practice participating in the insurance network to increase the insurance network'"'"'s profitability by limiting the plurality of physicians'"'"' ancillary medical cost management behavior that is not preferred by the insurance network; gathering data in a tangible computer medium from each of the plurality of physicians in the healthcare practice participating in the insurance network regarding management of ancillary medical costs respective to the physicians; modifying behavior of at least one of the plurality of physicians in the healthcare practice for management of the ancillary medical costs responsive to the data gathered in the tangible computer medium; determining whether the ancillary medical costs of the plurality of physicians in the healthcare practice have reached a preselected level within a preselected period of time funding an incentive pool to be paid to the insurance network when the modified medical management practices do not decrease ancillary medical costs of the insurance network to the preselected level over the preselected period of time; and distributing predetermined percentages of savings attributed to the modifying behavior of the plurality of physicians ancillary medical cost management to at least one of the insurance network and the healthcare management consultation group when the ancillary medical costs have decreased to the preselected level over the preselected period of time. - View Dependent Claims (14, 15, 16, 17, 18, 19)
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Specification