Topic7-JanhaviShah

Topic7-JanhaviShah

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Unformatted text preview: role in house reimbursed to healthcare provider because services from the TPA have been below expectation and the high volume has • Number of disputes with client • Commission charged made it cost effective for the insurance companies to settle claims themselves. Non­Governmental Organizations Opportunity My recommendationsRatings on basis of the following parameters NGOs have been primarily involved in NGO Ratings: provision of health care services for a very • Number of staff per 1000 population long time now. With a policy decision on • Socio-economic profile of the village Public-Private Partnerships as a means of catered to (example: High ratings increasing the provision of services to the for really poor and backward areas) population, NGOs have increased scope for • Beneficiaries of the NGO participation in the sector. 1. Financial Systems Analysis Rated NGOs will garner Public trust, It will be fruitful to direct funds to improved governance, management and NGOs with higher ratings operation and donor trust. With Credibility Alliance, an initiative by a network of 380+ NGOs; CRISIL staff can volunteer for the accreditation exercise. 13 The Grading Scale applicable to all recommendations: Grading Definition Grade 1 Very High Grade 2 High Grade 3 Good Grade 4 Below Average Grade 5 Poor 14 Emerging Opportunities in Healthcare Accreditation and Recommended Rating Parameters 15 Roles Which CRISIL Can Play While minimum standards of regulation are necessary, accreditation is to be of a voluntary nature. Thus, while regulation is purely a government job and accreditation and assessment system needs to be a private-public initiative. The standards should be periodically revised and today’s desirable standards should be tomorrow’s minimum standards. Some Suggestions: • Non-Financial Rating Services Offer rating services not only on basis of financial indicators, but non-financial operating indicators (example: average length of patient stay, occupancy rate) to measure success of operations and strategies for measuring hospital performance. CRISIL’s Function Client’s Function • Business Advisory CRIS...
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This document was uploaded on 01/14/2014.

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