Strategic alliances with organized providers. Provider Payment Providers paid on discounted fee for service and per diem basis. Physician organizations and hospitals capitated with joint risk-sharing arrangements. Utilization Management Utilization management focused on inpatient activity. Utilization management focused on inpatient and outpatient activity.
Utilization management incorporates clinical pathways and outcomes measurement.
Product Offerings Utilization management focused on inpatient activity. Utilization management focused on inpatient activity. Utilization management incorporates clinical pathways and outcomes measurement. Critical mass developed through aggressive pricing, product diversification, advertising, acquisition of weaker plans. Economies of scale.