Managed Care Revenue Consulting Group, LLC
 
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Gainsharing and Collaborative Initiatives

In 2006, the Partners of MCRC Group implemented an inpatient shared savings program at CHP that rewards physicians for reaching cost and quality benchmarks established by hospitals on managed care patients. Soon after the program began, the CHP hospitals began to see physician behavior changes that resulted in substantial cost reductions and improvement in quality. In 2008, CMS awarded one of the CHP hospitals with a waiver to perform the same gainsharing program with fee for service Medicare patients, hoping to see similar results for CMS. The success of both the managed care and Medicare fee for service program at CHP led Greater New York Hospital Association to start an initiative to expand the program to more member hospitals, and CMS to recently solicit hospitals around the country to participate in similar demonstrations. MCRC Group, along with Applied Medical Software, the company that holds the patent on the system that calculates the savings and incentive payments, now works with hospitals around the country to implement similar gainsharing and other hospital/physician collaboration programs that align the incentives of hospitals, physicians, and even payors. MCRC Group's knowledge of hospital operations, physician practice and payor processes, enabled it to help many hospitals structure programs that motivate physicians to practice more efficiently and improve quality outcomes, yielding rewards for all involved.

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