Program reimburses pharmacists who counsel patients on glyburide product.
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Insurers are using their purchasing power and their enormous stores of claims data to push hospitals to improve quality. Health plans are able to parse the data according to such quality indicators as cost, length of stay and outcomes. Hospitals are wary of the trend, but some welcome it, especially if insurers use the so-called pay-for-performance model.
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Acute and primary care trust relationships can be fraught with baggage, vagueness and stereotypes. Changing that is about overt behaviours as well as structural and strategic issues. Payment by results and attitudes to commissioning pose significant challenges.
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A lack of high-quality managers and a need for more commissioning muscle will encourage PCTs to merge. They will not be forced to do so by the government. Practice-based commissioning will take some responsibilities away from PCTs, but they will still have a big agenda. Trusts that have merged in all but name extol the benefits of keeping a local focus while freeing up resources from improved management capacity.
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