Would like to see 2-3 examples (case studies) on how some
organizations are trying new approaches to relationships between
healthcare payers and providers.  This should not simply be a
technology solution like EDI, but a true different approach to
collaboration to try to eliminate redundant processes and ultimately
provide better service and cost to the consumer.

Dear hlthresearch,

Journal of Healthcare Management has produced a case study on
Enhancing Care Delivery Through Cross-Disciplinary Collaboration (Free
registration required)
http://static.highbeam.com/j/journalofhealthcaremanagement/march011998/enhancingcaredeliverythroughcrossdisciplinarycolla/

The NHS Case Study
http://csdl.computer.org/comp/proceedings/ hicss/2004/2056/06/205660157a.pdf

Two good online case studies by Harvard Business school are available at:
http://harvardbusinessonline.hbsp.harvard.edu/b01/en/common/item_detail.jhtml?id=302019
http://harvardbusinessonline.hbsp.harvard.edu/b01/en/common/item_detail.jhtml?id=701007

Case study on GSK is available at:
http://www.groove.net/default.cfm?pagename=CaseStudy_GSK

A detailed case study on Quality Care Partners is available at:
http://www.paraprofessional.org/publications/QCPCaseStudy.pdf 

Siemens Medical Solutions lists many detailed case studies about
various companies in the healthcare sector. Unlike websites of others,
this site gives good case studies without merely highlighting their
products.
http://www.medical.siemens.com/webapp/wcs/stores/servlet/CategoryDisplay?storeId=10001&langId=-1&catalogId=-1&categoryId=18305&catTree=100005,18301,18305&level=0#anchor0

A very comprehensive paid resource for healthcare case studies is
American Productivity & Quality center.
http://www.apqc.org/portal/apqc/site/generic2?path=/site/industry_focus/industryfocus_healthcare.jhtml

Search strategy:
://www.google.co.in/search?hl=en&ie=UTF-8&oe=UTF-8&q=Healthcare+provider+customer+%22case+study%22&meta=
://www.google.co.in/search?num=100&hl=en&ie=UTF-8&oe=UTF-8&as_qdr=all&q=Healthcare+provider+customer++%22case+study%22+relationship+-collaboration&meta=

Hope that helps!

---

Request for Answer Clarification by hlthresearch-ga on 10 May 2004 11:28 PDT

I am specifically looking for strategies between a provider (hospital)
and payers (insurance companies). Usually these can be adversarial
relationships, but there may be cases where they try to work together
to lower both of their costs and thus deliver better quality/cost to
the ultimate consumer. Have heard rumors that there may have been some
studies done in Detroit or Mpls/St. Paul?

---

Clarification of Answer by kapilr-ga on 12 May 2004 07:54 PDT

Dear hlthresearch,

I will look up for more case studies as per your requirements and post them soon.

Best regards,

Kapil

---

Clarification of Answer by kapilr-ga on 13 May 2004 07:02 PDT

Dear hlthresearch,

Following are some case studies for your reference:

Insurance companies have saved costs by using the services of Third
Party Administrators. The hospitals have generated more business from
insurance companies. The consumers have gained by cashless
transactions and prompt medical attention.
"Hospital vs. TPAs - On a Warpath", by Gina S. Krishnan. Business
World (October 20, 2003).
http://www.businessworldindia.com/oct2003/news08.asp

A patient friendly Billing at Greenwich Hospital has been implemented
at Greenwich Hospital that has lead to improved liaison with patients
and insurance companies.
"Case Study: Patient Friendly Billing at Greenwich Hospital", by By
Leslie G. Bank, Director of Patient and Guest Relations, Greenwich
Hospital. Patient Friendly Billing Project.
http://www.patientfriendlybilling.org/pdf/greenwic.pdf
(Viewing this document requires that Adobe Acrobat Reader is installed)

Iowa state has formulated a case study on "Healthy Iowans" through
partnership with insurance companies and other stakeholders.
"The Healthy Iowans 2000 and Healthy Iowans 2010 Process: A Case
Study", by Christopher G. Atchison, Director, Iowa Department of
Public Health. Public Health Foundation, Washington DC.
http://www.phf.org/hp2010/ac1/casestud.htm

A patient friendly Billing at Greenwich Hospital has been implemented
at Greenwich Hospital that has lead to improved liaison with patients
and insurance companies.
"Case Study: Patient Friendly Billing at Greenwich Hospital", by By
Leslie G. Bank, Director of Patient and Guest Relations, Greenwich
Hospital. Patient Friendly Billing Project.
http://www.visioncompass.com/case_healthcare.pdf
(Viewing this document requires that Adobe Acrobat Reader is installed)
 
Additional links:
"Health Insurance for the Rural Poor? Community Financing Scheme in
Senegal to Protect against Illness": DSE (November/December 2001).
http://www.dse.de/zeitschr/de601-3.htm

"Health Plans' Innovative Programs in Breastfeeding Promotion", 4woman.gov.
http://www.4woman.gov/owh/pub/breastfeeding/case_stdy2.htm

"The case of Cure Hospital", VisionCompass
http://www.visioncompass.com/case_healthcare.pdf
(Viewing this document requires that Adobe Acrobat Reader is installed)


Search strategy:

://www.google.com/search?hl=en&lr=&ie=UTF-8&q=insurance+%22case+study%22+hospital+collaboration+-technology

Hope that helps!

This did not provide any information I could use.  Response after
clarification was worse than origianl - there was nothing included
about relationships between hospitals and insurers.