ABSTRACT
In the evolving pharmaceutical environment, the role of “provider organizations” (POs) has become increasingly prominent. The Institute for Health Improvement developed the “Triple Aim” framework in 2007 to optimize health system performance through improving the patient experience; improving the health of populations; and reducing the per capita cost of healthcare. In an increasingly competitive environment with preferred provider networks and negotiated rates, and under the push for value-based payment reforms, PO have focused to organize themselves to take advantage of payment incentives and adjust their business model to optimally align with the new performance metrics and payment structures. The POs are very focused on economics and their organizational excellence, to ensure that they can attract patients. The medical provider world is changing as a result of a shift from fee-for-service to value-based payment mechanisms and increasing public visibility of clinical performance metrics and patient satisfaction of hospitals and physician practices.
