Research Scope

The Healthcare Research Foundation focuses on researching healthcare delivery, its financial elements, and the transparency of statistical and mathematical measuring techniques required to accurately forecast future trends so that the industry members and general public can anticipate the future healthcare environment and adopt appropriate forward strategies.

 

While most authorities would agree that there has been considerable discussion about more sophisticated medical delivery models and medical care pricing methodologies, the industry as a whole has not materially improved in these areas over the past 20 years. The medical community may have better clinical technology and electronic medical record keeping capabilities, but it is still an industry that cannot accurately quantify, with adequate credibility, the healthcare cost efficiencies that have advanced beyond most historical standards.

 

THRF has the distinction of being able to predicate future research not only from an academic perspective, but on some very credible and proprietary previous experiences as well. In addition to our doctoral level research, previous commercial research projects have involved the development of medical care financing structures, adjudication arrangements, medical network development, volume purchasing agreement development and provider/physician delivery practices. Specifically, previous Healthcare Research Foundation building block studies included:

 

  • Health plan financial studies involving minimum premium, self-funding and unique stop-loss arrangements
  • Custom claim adjudication systems and the development of targeted risk sharing based withholding arrangements
  • Medical network development and the introduction of the initial private direct contracting methods
  • Developing and writing the syllabus for the first medical network contracting certification
  • Physician-hospital organizational development and developing the first financial models and corporate structures
  • Medical network pricing methods and best practice research pertaining to unit cost, utilization management, and outcomes development
  • Provider practice psychologies and the development of the first physician based defensive medicine study
  • Regional provider based health plan development and the creation of the initial hospital/physician based programs

 

Based on previous academic and practical experiences, as well as a consensus of seasoned healthcare research individuals, initial research questions and hypothesis considered will include:

 

  • The Affordable Care Act: Discovering how different levels of actual ACA growth impacts the administrative cost logics of the ACA program
  • Medical service discount contracting and the use of outcomes methodologies
  • Target based medical risk sharing and the impact on outcomes
  • Medical Outcomes: The relationship of target cost risk sharing and clinical metrics
  • Defining medical outcomes in relation to cost based targeting methods
  • Private medical network direct contracting as a viable medical management alternative
  • ACA Tax Subsidies: Addressing the tax credit variances and the impact of Medicaid
  • Electronic Medical Records: The impact on physician practice patterns
  • Physician Practice Protocols: The impact of liability limits and the physician mindset
  • Unit Medical Cost: The primary basis for healthcare discount contracting
  • Utilization controls and the pricing impact in physician and hospital discount agreements
  • The impact of additional intermediaries entering the healthcare marketplace by 2020
  • The relationship between Accountable Care Organizations and insurance carriers: The impact on current employer payer relationships
  • Health Insurance Distribution and Technology: The new members being drawn into this market space
  • The Pricing Model in the United States: The impact of industries that drive the market