Providers need to man­age in­for­ma­tion on de­liv­ery net­works

Modern Healthcare - - COMMENT -

Re­gard­ing the story “Providers, ad­vo­cates seek tougher rules on net- work ad­e­quacy” (ModernHealth­care.com, Nov. 20), as a con­sul­tant help­ing hos­pi­tals shore up their car­dio­vas­cu­lar ser­vice line or­ga­ni­za­tions, I too of­ten find the providers’ lo­gis­tics grossly frag­mented and out­dated. If the providers’ di­rec­to­ries are out­dated, or lack­ing in spe­cific sub­spe­cial­ists and/or pri­mary-care physi­cian cov­er­age, or lack­ing for­mal pa­tient trans­fer sys­tems from hos­pi­tal to hos­pi­tal as in the case of net­works in­volv­ing in­ner-city in­sti­tu­tions in­te­grated with ru­ral area hos­pi­tals, then the like­li­hood of the health plan be­ing up to speed is nil. Health plans can­not “man­age” care de­liv­ery. So it’s up to the hos­pi­tals and physi­cians to first demon­strate their will­ing­ness and abil­ity to bet­ter man­age these lo­gis­tics and then ed­u­cate their net­work plans to fol­low suit.

Con­rad Ver­non Heart & Vas­cu­lar Con­sul­tants Bur­net, Texas

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