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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
The cost to health plans was reported at between $10 and $25 per request by 2013. [2] It was estimated in 2009 that prior authorization practices cost the US healthcare system between $23 and $31 billion annually. [14]
Pay dispersion is defined as the ‘differences in pay levels between individuals within (i.e., horizontal dispersion) and across (i.e., vertical dispersion) jobs or organisational levels. [22] Vertical pay dispersion is specifically the difference in remuneration between the most senior employees of an organisation (e.g., Executive Directors ...
In December 2007, the President's Pay Agent reported that an average locality pay adjustment of 36.89% would be required to reach the target set by FEPCA (to close the computed pay gap between federal and non-federal pay to a disparity of 5%). By comparison, in calendar year 2007, the average locality pay adjustment actually authorized was 16.88%.
They negotiate with providers to set fee schedules and handle disputes between insurers and providers. PPOs can also contract with one another to strengthen their position in certain geographic areas without forming new relationships directly with providers.
A pay grade is a unit in systems of monetary compensation for employment. It is commonly used in public service, both civil and military , but also for companies of the private sector. Pay grades facilitate the employment process by providing a fixed framework of salary ranges, as opposed to a free negotiation.
A take-or-pay contract, or a take-or-pay clause within a contract, is a payment obligation agreed between a business customer and its supplier. With this kind of contract, the customer either takes the product from the supplier or pays the supplier a penalty. For any product the company takes, it agrees to pay the supplier a certain price, say ...
Instead of using a pre-determined rate based on estimates, businesses can base the overhead rate on the actual total manufacturing overhead cost and the actual total amount of the activity base incurred on a monthly, quarterly, or annual basis.