Glossary of Healthcare Operations Terms

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What is a Payvider?

A payvider, or payment provider, is a healthcare entity that both delivers care services and handles the financial aspects, such as billing and reimbursement, often seen in integrated healthcare systems.

In what context is a Payvider applicable?

Payviders can take on a few different forms: provider-sponsored health plans, employment of physicians by national payers, or long-term risk-based payer/provider contracts.

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Frequently asked questions

How do payviders differ from traditional healthcare providers?
Payviders, combining payer and provider functions, differ from traditional healthcare providers by handling both healthcare services and insurance functions. They aim to streamline the healthcare payment process by integrating care delivery and financing within a single entity.
What are the different forms of payviders in healthcare?
Payviders in healthcare encompass various models, including integrated health systems, accountable care organizations (ACOs), and health plans that provide both healthcare services and insurance coverage. These entities aim to streamline care delivery and financing for improved patient outcomes.
In what ways do payviders contribute to healthcare integration?
Payviders contribute to healthcare integration by combining healthcare delivery and payment functions. Integrated health systems, Accountable Care Organizations (ACOs), and health plans (payviders) streamline care coordination and financial processes, fostering a more cohesive and patient-centered healthcare approach.
How do payviders impact the healthcare landscape and patient experience?
Payviders impact the healthcare landscape and patient experience by integrating healthcare delivery and payment functions. This streamlines care coordination, improves patient access, and enhances the overall healthcare experience through a more integrated and patient-centered approach in healthcare operations.