Rx for negotiating.
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The medical director of this health plan established an innovative uniform infusion therapy fee whereby the plan pays a uniform infusion fee across all sites of care and contracts separately for delivery of the drug itself. The concept works successfully on three levels: (1) for plan members; (2) for plan providers; and (3) for the plan itself. This case study sets forth the conceptual and operational decisionmaking sequences involved. Establishing the innovative process required two primary elements: (1) coordinated decision making within all departments that were affected by the model; and (2) a champion to carry the project to a successful conclusion.
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