Lessons From Florida – The Patient-Centered Medical Home: Statewide Rollout

A primary care focused pay-for-performance program at Florida Blue has been transitioned this year into a statewide patient-centered medical home initiative.

While the Recognizing Physician Excellence program (RPE) program had moved the bar on quality metric performance, the move to the PCMH provides a look at both the quality and efficiency factors of a patient’s care.

An under-the-hood look into the details of this successful new program will be presented during The Patient-Centered Medical Home: Lessons from a Statewide Rollout, a 45-minute webinar on May 10th at 1:30 pm Eastern, Barbara Haasis, R.N., CCRN, senior clinical lead, quality reward and recognition programs at Florida Blue, will share how the health plan transitioned from the RPE program into a medical home model.
She will share:

  •     Lessons learned from the first year of a PCMH pilot program and how this shaped the statewide rollout;
  •     The criteria for which physician practices were selected to participate in the program;
  •     The shared savings approach through which practices will be reimbursed;
  •     The role of a nurse educator in helping the practices transform;
  •     Reporting practice results to drive further improvement;
  •     Results in total cost of care from physicians originally enrolled in the pay-for-performance program, now in the first quarter of the PCMH.

For more information or to register, please contact call 800-516-4343 or click on this link now: http://store.hin.com/product.asp?itemid=4401

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Are MCOs adequately addressing member satisfaction needs?

Related to the member communication initiatives of MCOs is meeting member\patient satisfaction.

So are health plans addressing patient satisfaction as a top priority?

This is question, from our Managed Care Leadership Survey, stirs strong opinions from providers, payers and others.

For instance: “No. Major carriers are doing just enough to maintain their satisfaction levels. They are also building their own satisfaction surveys to give the impression that they are top notch. A better way would to use a consistent measure like CAHPS to monitor.”

“Yes. New rules and bonus payments”

“No. Too little in the way of real tools, peer to peer assistance”

“No. Growing limits on provider access and increased carveouts are creating growing member dissatisfaction.”

“Yes. Adequately, yes. Meeting expectations, probably not. All depends on the benchmarks one is willing to use to measure member satisfaction.”

Source: Managed Care Information Center

Evaluating Oncology Management Programs: Trends in Payer Oncology Management and What You Need to Know for Success

MANASQUAN, NJ — Payers and providers across the country are grappling with choices for programs regarding oncology management and potential collaboration to control costs while also increasing the effectiveness of care.

There is a lot of discussion and many models being proposed for management of oncology costs. Both physicians and payers are seeking information to help in separating the wheat from the chaff and looking for help in choosing the best model for their needs especially in this challenging climate.

Evaluating Oncology Management Programs:Trends in Payer Oncology Management and What You Need to Know for Success is a 60-minute audio webcast scheduled for December 2, 2010, at 1:30 p.m. EST.

This program identifies the issues of concern in oncology management, outlines the current seven models under discussion/implementation, and reviews the players, pros and issues with each model.

Participants will learn how to:

  • Evaluate the results of two oncology trend reports while learning key perspectives on oncology policy and management from both payers and physicians as well as implications of the study results
  • Review the details of oncology management and collaborative models in play across the country, including drug pricing, guidelines and pathways
  • Understand how to evaluate the current models and what questions to ask in choosing a best fit for your organization
  • Develop strategies regarding oncology management and take away steps for implementation and collaboration with oncology providers

The session also includes:

  • Live Open Line question and answer session

The presenter for the program is Dawn G. Holcombe, president of
DGH Consulting and is sponsored by The Managed Care Information Center.

For complete details, please visit:
www.healthresourcesonline.com/edu/Evaluating-Oncology-Management-Programs.htm