EXTERNAL FACTORS AFFECTING
YOUR CENTER'S OPERATIONS
| Type of Organization | Organization | Type of Impact |
| Insurers | Medicaid Medicare Purchasing alliances |
Moving to managed care Reimbursement restrictions Capitation/bundling of services |
| Employers | Employer coalitions | Negotiating directly with providers Restrict covered services |
| Government | Entitlement programs Regulatory programs |
Funding and eligibility restrictions Added administrative costs (i.e. HIPAA*) Added reporting burden |
| Competition | Networks Private Sector |
Market share diminishing Competition for staff/patients |
| Managed Care | HMO PPO |
Funding restrictions Gatekeeper Limitation on services covered |
*HIPAA = Health Insurance Portability and Accountability Act