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The <br />Welch <br />c~,P~y <br /> <br />f~ <br />Alternative Healthcare Delivery Systems <br />-~ Part three of six components of a Model for Health Plan Review <br />Armed with the knowledge gained from steps #9 -Risk Evaluation and <br />Management and #2 -Plan Design Evaluation, the consultant must <br />ascertain which delivery mechanisms produce the best service for the most <br />efficient price. <br />Sometimes the delivery system resides "outside the box," so the plan <br />sponsor may need to consider some non-traditional methods. <br />-- As boutique delivery systems mature within the healthcare field, their <br />impact on plan dollars can be very positive. A perfect example would be <br />the popularity of Employee Assistance Programs in the past and the <br />subsequent reduction in mental and nervous disorder costs within health <br />plans. <br />-~ Some of the A/temative DeliveN Systems to be reviewed include: <br />- Direct provider contracting <br />- Illness specific services <br />- Exclusive Provider Organizations <br />- Network contract evaluation <br />- Centers of excellence <br />- Pool alternatives <br />It may be mandatory that the health plan be organized in aself-funded <br />atmosphere to facilitate the inclusion of many of the altemative delivery <br />systems. <br />The self-funded environment more than the insured environment should <br />produce the data needed to direct, implement and evaluate the impact of <br />the altemative delivery systems. <br />