When I started my career in health care, quality improvement was the domain of “numbers types” who reported up to operations. But those were different times. Health care services were bought (and sold) like commodities – all licensed professionals and programs were assumed to be roughly the same. Payment was made for every unit of service and the role of health insurance companies was limited. They processed claims for services and charged an administrative fee for doing it. Everyone (except the payer) – the consumer, the health care organization, and the insurance company – profited from higher service utilization. We are now in . . .
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