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| 7. | At your practice, of the spectacle lenses you dispense, what percentage are A/R coated? |
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Number of beds in your organization: |
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How much will your organization spend on renovation/construction projects in the next 12 months? |
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In the performance of my job, I buy, specify and/or influence the purchase of the following products: (select all that apply) |
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Which of the following products do you recommend, specify or purchase? (select all that apply) |
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Which of the following BEST describes the primary business of your organization or division? (select only one) |
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A. HEALTHCARE PLAN, PAYOR & ADMINISTRATIVE ORGANIZATIONS: |
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HMO/PPO/PSO/Insurance Company |
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Medicare/Medicaid/Governmental Plan |
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Supplemental/Carve-Out Insurance Plan (Dental/Vision/Behavioral Health) |
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Pharmacy Benefits Management (PBM) including Medicare Part D PDP |
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Third Party Administration (TPA) |
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Utilization Review Firm |
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Contract Management Firm |
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Group Purchasing Organization (GPO) |
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Employee Benefits Management (EBM) Firm/Consultant |
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Other Healthcare Plan, Payor & Administrative Organization |
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Please specify for Other: |
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B. HEALTHCARE PROVIDER ORGANIZATIONS: (An entity that directly treats patients) |
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Integrated Health Organization (IHO) (multi-hospital/practice settings; same ownership) |
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Integrated Delivery System (IDS) (multiple practice settings; same ownership) |
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Integrated Health Network (IHN) (multi-hospital; separate ownership) |
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Multi & Large Group Practice (50+ physicians) |
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Multi & Large Group Practice (less than 50 physicians) |
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Independent Hospital (300+ beds) |
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Independent Hospital (less than 300 beds) |
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Independent Practice Association (IPA) |
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Medical Clinic (50+ physicians) |
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Medical Clinic (less than 50 physicians) |
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Long-term Care Facility or Multi-Facility |
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Home Healthcare Organization |
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Other Healthcare Provider Organization |
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Please specify for Other: |
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C. INDEPENDENT CONSULTANT |
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D. NON-HEALTHCARE EMPLOYERS OF: (Aerospace, Automotive, Banking/Financing, Construction, Consumer Goods, Energy, Federal & State Government, Food/Grocery, IT–Hardware & Software, Retail) |
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5,000+ Employees |
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1,000 - 4,999 Employees |
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200-999 Employees |
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E. OTHER |
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Please specify for Other: |
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Which of the following titles & specialties BEST describes your highest current management position in the business organization selected in the above question? (select only one) |
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NON-CLINICAL EXECUTIVE: |
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Chief Executive: CEO/COO/President/Executive Director/Owner/Principal/VP/Director |
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Managed Care Executive: Chief/VP/Director |
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Administrative Executive: VP/Director |
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Financial Executive/Contracting Executive/Industry Relations Executive: CFO/VP/Director/Treasurer/Controller |
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Information Technology & Intelligence Services Executive: CIO/VP/Director (Software, Hardware, Web, Data Processing, Technology Assessment) |
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Medical Records Executive: VP/Director |
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Marketing Executive: CMO/VP/Director |
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Sales Executive: CSO/VP/Director |
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Patient Relations/Member Services Executive: VP/Director |
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Human Resources Executive: VP/Director |
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Employee Benefits Executive: VP/Director |
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Legal/Regulatory/Affairs Executive: Chief Counsel/VP/Director |
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Risk Management Executive: VP/Director |
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Other Non-Clinical Executive: VP/Director |
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Please specify for Other: |
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CLINICAL EXECUTIVE: |
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Medical Director |
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Chief of Medicine/Chief of Staff |
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VP/Director/Chief of Medical Affairs |
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Clinical Program Director/Services VP/Director (Specify: e.g., Oncology, Sports Medicine, Transplant, Disease, ER, Trauma, Wellness, Physical Therapy, Radiology, etc.) |
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Please specify: |
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Pharmacy/Formulary Director/Formulary Committee Chair |
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VP/Director/Chief of Pharmacy Services |
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Drug Information Officer/Clinical Pharmacist |
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VP/Director of Nursing/Chief of Nursing Affairs |
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Utilization Review/Quality Assurance VP/Director |
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Case Management VP/Director |
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Provider Relations VP/Director |
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Other Clinical Executive: VP/Director |
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Please specify for Other: |
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Total number of lives covered if at a Managed Care Plan/Payor Organization: |
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Tell us what you really think. Join Managed Healthcare Executive Research Panel today. |
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