Administrative Services –
The Engine for Health
“Our experience of contracting with provider networks and sharing data between multiple organisations has delivered improved operational efficiencies, lower costs and a superior patient experience”
At the heart of effective commissioning lies an administrative infrastructure that enables PCTs to get the best possible return from available resources across all areas of their services.
Contracting and procurement is a fundamental skill-set for any commissioner of health and healthcare. At Humana, we have extensive experience in negotiating contracts with all types of healthcare providers. We have cutting-edge systems in place to build on existing relationships and to procure and manage new providers. Our approach has consistently resulted in more choice for patients, improved access and better value for money.
We work closely with PCTs to help shape their supply structure. Our enhanced management information system draws on data from a range of sources – primary, secondary, pharmacy, dental and mental health. This solid foundation of data helps PCTs to make better contracting decisions, identify cost-saving opportunities and centralise certain administrative and clinical management functions. It also enables them to establish benchmarks to monitor their own performance.
Practice-based commissioning is still a developing area for the NHS in England, and we at Humana understand the infrastructure and expertise it requires. Our research has consistently demonstrated the type of support that GPs want in rolling out this new model of commissioning health services. And having established one of the largest provider networks in the US – incorporating hospitals, specialists, primary care physicians and ancillary services – we are well placed to provide the support you need to make commissioning a success.
Humana’s administrative services include:
- Data mining and analysis for process improvement
- Negotiating contracts, assessing and configuring provider networks
- Analysing KPIs for gaps and assessing for potential improvement
- Assessing and evaluating PCTs relative to KPIs
- Coordinating with PCT and SHA management groups
- Offering PCTs and GPs budgetary compliance help
- Consolidating reporting including the ability to create bespoke reports on specific patient populations
- Improving capacity planning through predictive modelling and data analysis
- Governance
Benefits of Humana’s administrative services:
For Patients
- Contracting with acute providers for the provision of services based on sound and accurate forecasting ensures the patient populations’ needs are better catered for
- The provision to general practitioners of detailed reports on their specific patient populations will encourage more efficient servicing of clinical needs
- More detailed and accurate reports to general practitioners on referral situations, such as those that capture checks made for a variety of conditions, will enhance the quality of care for the individual patient
For PCTs
- More accurate and detailed contracting with providers resulting in proper allocation of resources and a reduction in wastage of funds
- Increased accuracy of payments for services through the systematic checking of clinical coding
