Medical Cost Management

• Contracting

  • Focused on lowering hospital trend through innovative contracting methods such as Medicare Allowable/DRGs (i.e., Tenet)

• Medical Management

  • Shared member and physician decision-making
  • Evidence-based medicine
  • Hospital accountability/HealthShare
  • Improving ALOS
  • Impacting admits through Disease Management programs
  • Pharmacy management

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