3/24/2016. The Future of the Laboratory: Patient as Consumer. Disclosure. Learning objectives: Relevant Financial Relationship(s) None
|
|
|
- Shannon Reynolds
- 5 years ago
- Views:
Transcription
1 The Future of the Laboratory: Patient as Consumer Jane M. Hermansen MBA, MT(ASCP) ASCLS-MO/STL CLMA 2016 Spring Meeting April 5, MFMER slide-1 Disclosure Relevant Financial Relationship(s) None Off Label Usage None 2015 MFMER slide-2 Learning objectives: Define the factors that influence patient behavior, current and in the future Describe the value that laboratory diagnostics play in the future healthcare environment Develop a plan to incorporate patient-focused support into the laboratory s service 2015 MFMER slide-3 1
2 INFLUENCERS OF PATIENT BEHAVIOR Demographic Psychographic Current & Future 2015 MFMER slide-4 Demographic Increasing demand for services More insured Medicare Chronic illness Increasing comorbidity Shift in care provision Outpatient Primary Care gatekeepers 2015 MFMER slide-5 Attributes that Drive Patient Choice Appointment flexibility Lab is accessible Insurance Availability/hours Education Consistent Community Location The Advisory Board Company 2015 MFMER slide-6 2
3 Psychographic Tech-savvy Online Self-help Informed and engaged Seek to drive or control own care Price-sensitive Loyalty conundrum Primary -vs- Specialty 2015 MFMER slide-7 Use of Technology and Benefits Google-ization of medicine Patients are no longer satisfied with just meeting with their doctors. Increasingly, they expect to access lab results on their phones soon after leaving the medical center. Better informed patients use less healthcare services 2016 AHA Environmental Scan 2015 MFMER slide-8 Engaged Patients "I deserve more. I want to be healthy. I want to help manage my care and my health. I want to see every piece of data you have. The Patient of the Future, Gienna Shaw, HealthLeaders Media, September 10, MFMER slide-9 3
4 The Rise of Consumerism >75% of exchange customers list premium and out-of-pocket cost as extremely or very important Range of benefits (61%) Choice of providers (60%) 2015 MFMER slide-10 Increasing Medical Debt 43% of patients indicated their deductible was somewhat, very difficult, or impossible to afford Unexpected medical bill (not covered by insurance) = $1,500 31% pay it off without going into debt 43% would have to go into credit card debt or borrow money to pay it 15% would not be able to pay at all MFMER slide-11 Cost-Prohibitive Care In January through March 2015, 4.4% of the population failed to obtain needed medical care due to cost at some time during the past 12 months Clarke TC, Ward BW, Freeman G, Schiller JS. Early release of selected estimates based on data from the January March 2015 National Health Interview Survey. National Center for Health Statistics. September Available from: MFMER slide-12 4
5 Commoditization of Service Patients view Primary Care and associated services (including laboratory) as commodities Most highly-valued attributes (rank): Access and Convenience (1-4) Continuity (5) Credentials (8) Commodities are most susceptible to price-shoppers The Advisory Board Company 2015 MFMER slide-13 What about Brand Loyalty? 53% are loyal to primary care but would switch if they had a compelling reason 1. No longer accept insurance 2. Cost >$250/year additional 3. Error/poor experience Brand or affiliation is of little importance (19) unless specialty care is needed 1. Distance 2. Affiliation 3. Quality The Advisory Board Company 2015 MFMER slide-14 The Phantom Appeal Autonomy/Control Direct Access Testing Access Walgreens Pricing 50% Medicare CLFS Transparency Complete test menu and fees published online Experience Schedule/No wait Spa-like Less pain Innovative New technology Fast turnaround time Results available online Compelling leader 2015 MFMER slide-15 5
6 DIAGNOSTIC VALUE IN HEALTHCARE Integrate Across Continuum of Care Align for Wellness Assist in Managing Population Health 2015 MFMER slide-16 The Laboratory and the Continuum of Care Source: Sg2.com 2015 MFMER slide-17 Realigning the Purpose of Laboratory Testing 2015 MFMER slide-18 6
7 High Value Diagnostics Support population-based initiatives Population Health Management Triple Aim Payment models Shift to prevention Reward wellness 2015 MFMER slide-19 Population Health Management Proactive Model ABILITY TO IMPACT SITUATIONAL RISK Family Hx Environment EARLY RISK Diet Exercise HIGH RISK Cholesterol BP Blood sugar SYMPTOMATIC ILLNESS Active Dz Diabetes COMPLEX ACTIVE ILLNESS 80% OF COSTS LIFETIME 2015 MFMER slide-20 The Triple Aim (Institute for Healthcare Improvement) Improving the patient experience of care Improving the health of populations Reducing the per capita cost of health care MFMER slide-21 7
8 Technologic Enhancements Personalized medicine -omics Wearables Etc This is not the enemy 2015 MFMER slide-22 THE PATIENT-FOCUSED LABORATORY Exceed Expectations Address Consumer Needs Enhance Service and Support Create Loyalty 2015 MFMER slide-23 Cycle of Patient Choice and Points of Contact The Advisory Board Company 2015 MFMER slide-24 8
9 Relationship Management Focus: Quality Value Community Remove the hurdles Access Transparency Affordability Develop consumer loyalty Customer-focused staff Personal connections Repeat business Integrate laboratory into the larger picture of care 2015 MFMER slide-25 A Call to Action Management is doing things right. Leadership is doing the right things. ~Peter Drucker 2016 FMER slide-<#> 2015 MFMER slide-26 The Tale of Two Questions What s the matter with you? What matters to you? 2015 MFMER slide-27 9
10 Accept the New Reality When the wind is blowing at gale force, there's no point in sailing against it If patients don't want to receive laboratory services from you: 1. Listen 2. Understand 3. Adapt and change 2015 MFMER slide-28 Change is Inevitable The patient of the future demands to know how much each appointment, test, outpatient procedure, or hospital stay will cost them down to the very last prescription pill. And they use price and quality data to make decisions about where they go for care. The Patient of the Future, Gienna Shaw, HealthLeaders Media, September 10, MFMER slide-29 Exceed Consumer Expectations Transparency Price Posted hours of service Online scheduling Access Convenient locations Extended hours Positive Encounter Maps and wayfinding No waiting Durable Relationship Historic information Know them Care The Advisory Board Company 2015 MFMER slide-30 10
11 Questions & Discussion 2015 MFMER slide-31 Contact Information Jane M. Hermansen, MBA, MT(ASCP) Manager, Network and Outreach Development Mayo Medical Laboratories 3050 Superior Drive NW Rochester, MN Toll free: MFMER slide-32 11
HealthPartners and the Triple Aim. IHI Open School August 23, 2012 Beth Waterman, RN MBA Chief Improvement Officer HealthPartners
HealthPartners and the Triple Aim IHI Open School August 23, 2012 Beth Waterman, RN MBA Chief Improvement Officer HealthPartners HealthPartners Not for profit, consumer governed Integrated care and financing
Basic, Including 100% Part B Coinsurance. Part B Coinsurance. Coinsurance* 50% Skilled Nursing Facility Coinsurance. Nursing Facility Coinsurance
LOYAL AMERICAN LIFE INSURANCE COMPANY P. O. BOX 26580 AUSTIN, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, G and N This chart shows the benefits included in
A B C D F F* G K L M N Basic, including 100% Part B coinsurance. Basic, including 100% Part B coinsurance
This chart shows the benefits included in each of the standard Medicare supplement plans. Every company must make Plan A available. Some plans may not be available in your state. AmeriHealth Insurance
Basic, including 100% Part B coinsurance. Basic, including coinsurance. Basic, including coinsurance* Basic, including
CIGNA HEALTH AND LIFE INSURANCE COMPANY PO Box 26580, Austin, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, High-Deductible F, G, and N This chart shows the benefits
Basic, including 100% Part B coinsurance. Coinsurance Part A Deductible Part A Deductible Part A Deductible Part A Deductible Part A Deductible
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUECARE COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, B, G and F This charts
Basic, including 100% Part B coinsurance. Foreign Travel Emergency
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUECARE COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, B, D and F This charts
Basic, including 100% Part B coinsurance. Foreign Travel Emergency
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, B, D and F
Basic, including 100% Part B coinsurance. Coinsurance Part A Deductible Part A Deductible Part A Deductible Part A Deductible Part A Deductible
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF BLUECARE COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, C, D and F This charts
4/18/2013. Why Quality Matters. Overview. Discussion
Why Quality Matters Margaret E. O Kane, NCQA President April 18, 2013 Overview Who is NCQA? How do we help brokers? Employers views and quality and value About high-deductible plans Discussion 2 My Presentation,
Outline of Medicare Supplement Coverage - Standard Benefits for Plans A, B, F, High Deductible Plan F* and N
A Division of Health Care Service Corporation, A Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Outline of Medicare Supplement Coverage - Standard Benefits
Basic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing.
UNITED OF OMAHA LIFE INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, D, F AND G These charts show the benefits included in each of the
A B C D F F* G K L M N. Basic Benefits. Basic Benefits* Skilled Nursing Facility Coinsurance Part A Deductible Part B. 50% Skilled Nursing Facility
Outline of Medicare Supplement Coverage Standard Benefit for Plan A, Plan F, High Plan F*, Plan N, and Blue Plan65 Select Benefit for Plan F and Plan N This chart shows the benefits included in each of
Medical Plan Options - Retirees Age 65 or Over/ Disabled Participants with Medicare Coverage
Program Name U of M Retiree Plan with Group MedicareBlue SM Rx Group Platinum Blue SM Plan C with Group MedicareBlue SM Rx Freedom Plan & Freedom Plan & Type of Policy Coordinates with Medicare and includes
Blue Shield of California
An independent member of the Blue Shield Association City of San Jose Custom ASO PPO 100 90/70 Active Employees Benefit Summary (For groups of 300 and above) (Uniform Health Plan Benefits and Coverage
Highmark Blue Cross Blue Shield West Virginia *Changes effective January 1, Market Street P.O. Box 1948 Parkersburg, West Virginia 26102
Highmark Blue Cross Blue Shield West Virginia *Changes effective January 1, 2011 614 Market Street P.O. Box 1948 Parkersburg, West Virginia 26102 Outline of Medicare Supplemental Benefit Plans A, C, F,
Medicare SELECT. Supplement Plans A, C, F & N. Plans C & N Outline of medicare supplement coverage
Medicare Supplement Plans A, C, F & N & SELECT Plans C & N 2011 Outline of medicare supplement coverage BENEFIT CHART OF MEDICARE SUPPLEMENT PLANS Sold for Effective Dates on or After JANUARY 1, 2011
Retail health & wellness Innovation, convergence, and healthier consumers
Retail health & wellness Innovation, convergence, and healthier consumers Can industry convergence and innovative offerings lead to profitable health care services and healthier consumers? Traditional
Basic, including 100% Part B coinsurance. Foreign Travel Emergency
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF MEDICARE SELECT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS TRADITIONAL A and
Plan F & Plan F* Skilled Nursing Facility Coinsurance Part A Deductible Part B. Deductible. Part B Excess (100%) Foreign Travel Emergency
Outline of Medicare Supplement Coverage By Reason of Age Cover Page: Benefit Plans A, F, High F, G, and N See Outlines of Coverage sections for detail about all plans. This chart shows the benefits included
Medicare Supplement Plans
KPShealth plans P R O V I D E R N E T W O R K If you have questions about any of our Medicare Supplement plans or about the application process, please feel free to contact us at 360-478-6786, or toll
Basic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER Skilled Nursing
MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, B, C, D, F, G, AND M These charts show the benefits included in each of the standard Medicare supplement
Basic, including 100%
OMAHA INSURANCE COMPANY A Mutual of Omaha Company OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, D, F, AND G This chart shows the benefits included in each of the standard Medicare
Medicare. Supplement Insurance
Medicare Supplement Insurance EVEREST REINSURANCE COMPANY Outline of Medicare Supplement Coverage Benefit Plans A, C, D, F, G, and N Benefit Chart of Medicare Supplement Plans Sold for Effective Dates
Hospital Urgent Care Operations: A Pathway to Profitability
Hospital Urgent Care Operations: A Pathway to Profitability Alan A. Ayers, MBA, MAcc Chief Executive Officer, Velocity Urgent Care Vice President of Strategic Initiatives, Practice Velocity, LLC Practice
EXCLUSIVE CARE SUMMARY OF COVERED BENEFITS Select Medicare Eligible Supplement Plan
2018 EXCLUSIVE CARE SUMMARY OF COVERED BENEFITS Select Medicare Eligible Supplement Plan Summary Table of Benefits Select Medicare Supplement Plan PLAN REIMBURSEMENT METHOD DEDUCTIBLE - Individual Medicare
Examining the Differences Between Commercial and Medicare ACO Models
Examining the Differences Between Commercial and Medicare ACO Models Michelle Copenhaver December 10, 2015 Agenda 1 Understanding Accountable Care Organizations 2 Moving to Accountable Care: Enhancing
California s Chronically Ill: Coping with Rising Health Care Costs
California s Chronically Ill: 2005 Introduction As health plan coverage continues to move towards member cost sharing, particular concern has been raised about the impact of these changes on those with
Value Based Care An ACO Perspective
Value Based Care An ACO Perspective NCIOM Task Force on Accountable Care Communities January 24, 2018 Steve Neorr Chief Administrative Officer 2 3 4 5 Source: Banthin, Jessica. Healthcare Spending Today
Integration of a Standardized Scalable Solution for Video Telemedicine into the Traditional Practice Model
Integration of a Standardized Scalable Solution for Video Telemedicine into the Traditional Practice Model Stacia Lynch gptrac Regional Forum 2014 April 3, 2014 2014 MFMER slide-1 Mayo Clinic in Minnesota
Skilled Nursing Facility. Part A. 50% Part A Deductible. Part A Deductible. Deductible. Part B Excess (100%) Foreign Travel. Foreign Travel Emergency
OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE BENEFIT PLANS A, C, D, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans. Every
Clinical Integration Track. Terry Wooten,
Clinical Integration Track Putting Ideas and Theories to the Test in Clinical Effectiveness and Improved Outcomes Terry Wooten, VP, Clinical Supply Chain, St. Joseph Health Not-For-Profit Integrated Catholic
FirstHealth Moore Regional Hospital. Implementation Plan
FirstHealth Moore Regional Hospital Implementation Plan FirstHealth Moore Regional Hospital Implementation Plan For 2016 Community Health Needs Assessment Summary of Community Health Needs Assessment Results
Building an Ambulatory System of Care: Using Population Health to Combat Secular Trends & Achieve the Triple Aim
Building an Ambulatory System of Care: Using Population Health to Combat Secular Trends & Achieve the Triple Aim Christopher T. Olivia, MD, President June 11, 2014, All Rights Reserved and CONTINUUM HEALTH
Ambulatory Care Delivery Strategy: The Key to Successful Population Health Management
Ambulatory Care Delivery Strategy: The Key to Successful Population Health Management Christopher T. Olivia, MD, President Michael Renzi, DO, Chief Medical Officer March 18, 2014 2014, Continuum Health
member handbook blueshieldca.com/bscbluegroove
member handbook blueshieldca.com/bscbluegroove With Main Groove, you get a Personal Physician from our medical provider network, and predictable, lower outof-pocket costs than with Basic Groove, plus access
ENHANCING PRESCRIBER RELATIONSHIPS: MAKING IT A WIN-WIN JULY 12, :00 5:00 PM
ENHANCING PRESCRIBER RELATIONSHIPS: MAKING IT A WIN-WIN JULY 12, 2017 3:00 5:00 PM ACPE UAN: 0107-9999-17-105-L04-P 0.2 CEU/2.0 hr Activity Type: Knowledge-Based Learning Objectives for Pharmacists: Upon
Connected Care Partners
Connected Care Partners Our Discussion Today Introducing the Connected Care Partners CIN What is a Clinically Integrated Network (CIN) and why is the time right to join the Connected Care Partners CIN?
Introducing a new Medicare Advantage Plan
Introducing a new Medicare Advantage Plan Healthy Partnerships are our specialty. At Arkansas Health & Wellness we are dedicated to creating the best healthcare plans for your patients. And, as our partner,
Anthem Blue Cross Effective: January 1, 2017 Your Plan: University of California High Option Supplement to Medicare
Anthem Blue Cross Effective: January 1, 2017 Your Plan: University of California High Option Supplement to Medicare Please Note: this medical plan is a complement to your existing Medicare plan. Medicare
Community Health Needs Assessment: St. John Owasso
Community Health Needs Assessment: St. John Owasso IRC Section 501(r) requires healthcare organizations to assess the health needs of their communities and adopt implementation strategies to address identified
First Look: Plan Benefit Filings
July 30, 2014 First Look: Plan Filings Maryland and Washington, D.C. 1 Disclaimers MedStar does not currently have a contract with CMS for the State of MD nor any special needs plans in Washington, D.C.
Medicare Supplement Coverage Options
Medicare Supplement Coverage Options Thank you for your interest in our Medicare Supplemental coverage options, also known as HealthNow New York Inc. Medicare Supplement (Medigap) plans. The Medicare Supplement
Retail Healthcare: What Providers Can Learn
Retail Healthcare: What Providers Can Learn Healthcare Marketing And Physician Strategies Summit April 14, 2015 1 Our Speakers Today Mark Coughlin is a Partner with Capital Healthcare Planning. He has
Verdien av egengenerert helsedata. Oslo, Tor Jakob Ramsøy
Verdien av egengenerert helsedata Oslo, 1.9.2015 Tor Jakob Ramsøy torjakob@arundo.com 0 Patient Generated Data is not new, but has taken on a much bigger role in this new era of data abundance and ubiquitous
2019 Summary of Benefits
2019 Summary of Benefits H6351 This is a summary of drug and health services covered by January 1, 2019 - December 31, 2019. is Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization)
Americo Application Packet
Americo Application Packet Thank you for your interest in applying for the Americo Medicare Supplement plan! This application packet provides you with access to a printable copy of the Enrollment Form
Medicare & Medicare Supplemental Insurance (Medigap)
Elder Law Basics Medicare & Medicare Supplemental Insurance (Medigap) Steven A. Kass, Esq., CELA Law Office of Steven A. Kass, PC 105 Maxess Road, Suite N116 Melville, New York 11747 What is Medicare?
Strategic Growth and Physician Engagement Platforms: The Core of Population Health
Strategic Growth and Physician Engagement Platforms: The Core of Population Health Relevancy in Both a Volume and Value-Based World SHSMD U Sponsored Webcast: The Next Evolution of Business Intelligence
Schedule of Benefits-EPO
Schedule of Benefits-EPO [Plan Information] [Health Plan:] [Ambetter Balanced Care 3 (2018)-Standard Silver On Exchange Plan] [Primary Member:] [John Doe] [Member ID:] [01213456] [Date of Birth:] [08/12/62]
Irvine Unified School District ASO PPO /50
An Independent member of the Blue Shield Association Irvine Unified School District ASO PPO 500 90/50 Benefit Summary (For groups of 300 and above) (Uniform Health Plan Benefits and Coverage Matrix) THIS
BETTER INFORMED. BETTER TOGETHER.
BETTER INFORMED. BETTER TOGETHER. easy to get appointments free to focus on my patients excellent prenatal care test results online I can choose my doctor wide range of specialists I m part of the decision
Summary of Benefits. January 1, 2018 December 31, Providence Medicare Dual Plus (HMO SNP)
Summary of Benefits January 1, 2018 December 31, 2018 Providence Medicare Dual Plus (HMO SNP) This plan is available in Clackamas, Multnomah and Washington counties in Oregon for members who are eligible
2019 Summary of Benefits
2019 Summary of Benefits H6345 This is a summary of drug and health services covered by January 1, 2019 - December 31, 2019. is Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization)
5/30/2012
The Affordable Care Act Background Coverage Long-term Care Home and Community Based Services Payment Delivery Care Transitions Assuring Quality Supreme Court 5/30/2012 www.nasuad.org BACKGROUND Health
All but Part A Deductible. Medicare Part A Deductible. Nothing. Inpatient Hospital All but Part A Medicare Part A Nothing.
Summary of Signature 65 Benefits Signature 65 is a Medicare-complimentary benefit program that fills in the coverage gaps and cost sharing of the traditional Medicare program (Medicare Part A and ). In
HEALTHY EMPLOYEES HEALTHY EMPLOYEE BENEFIT PLAN
HEALTHY EMPLOYEES HEALTHY EMPLOYEE BENEFIT PLAN At a point in time when many employers are forced to cut benefits healthcare costs are increasing at 3 to 4 times the rate of inflation access to quality
Critical Access Hospitals and Cost-Based Reimbursement
Critical Access Hospitals and Cost-Based Reimbursement Jared Heim, CPA, Partner jheim@eidebailly.com 563.557.6169 Agenda for Today Overview of Critical Access Hospitals Overview of Health Care Reform Behavioral
5Ways to Reduce Your Out-of-Pocket Expenses
1 Go Generic. You can save money on prescriptions by getting a generic equivalent of your medication. According to the U.S. Food and Drug Administration, generic drugs must have the same active ingredients,
2009 BENEFIT HIGHLIGHTS HEALTH NET PEARL HAWAII OPTION 1
2009 BENEFIT HIGHLIGHTS HEALTH NET PEARL HAWAII OPTION 1 Hawaii, Honolulu, Kalawao, Kauai and Maui counties MEDICAL COVERAGE Monthly Plan Premium $0 Calendar Year Out-Of-Pocket Maximum1 $1,200 Inpatient
Health plans for New Hampshire small businesses Available through the Health Insurance Marketplace
Health plans for New Hampshire small businesses Available through the Health Insurance Marketplace 1 38476NHEENABS Rev. 09/14 We can help you navigate the health care road We re here to help. In fact,
September, James Misak, M.D. Linda Stokes, MSPH The MetroHealth System
Better Health Greater Cleveland relies on the presenter to obtain all rights to use and display copyright-protected information. Anyone claiming a right or interest in or to any posted information should
HEALTH PLAN BENEFITS AND COVERAGE MATRIX
HEALTH PLAN BENEFITS AND COVERAGE MATRIX THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE AND PLAN CONTRACT SHOULD BE CONSULTED FOR
Providence Medicare Advantage Plans
This is an advertisement Providence Medicare Advantage Plans 2018 Plan Comparison King and Snohomish County Service area map Snohomish King 2018 Providence Medicare Service Area Summit + RX (HMO-POS) Harbor
INFObrief Deloitte 2012 Survey of U.S. Health Care Consumers Consumers utilization of the health care system
INFObrief Deloitte 2012 Survey of U.S. Health Care Consumers Consumers utilization of the health care system Background This INFOBrief presents key findings about consumers utilization of the U.S. health
Providence Medicare Advantage Plans
This is an advertisement Providence Medicare Advantage Plans 2018 Plan Comparison Western Oregon, Tri-County and Clark County, Washington H9047 _ 2018PHA38 _ ACCEPTED Service area map Columbia Clark Washington
Patient Protection and Affordable Care Act Selected Prevention Provisions 11/19
Patient Protection and Affordable Care Act Selected Prevention Provisions 11/19 Coverage of Preventive Health Services (Sec. 2708) Stipulates that a group health plan and a health insurance issuer offering
Building a Multi-System Clinically Integrated Network
Building a Multi-System Clinically Integrated Network 22 nd Annual AHA Leadership Summit July 2014 Valence Health Has Been Helping Provider Organizations Progress Toward Value-Based Care Since 1996 Technology-enabled
EVERY DAY. we strive to change lives for the better by addressing our community needs. in community benefits SERVING MORE THAN 563,000
EVERY DAY we strive to change lives for the better by addressing our community needs. In 2013 we provided over $199 million in community benefits SERVING MORE THAN 563,000 people through our outreach programs.
2
1 2 3 4 5 Types of Medicare Part A Hospital insurance (inpatient hospital care, inpatient care in a Skilled Nursing Facility, hospice care, and some home health services); Part B Medical insurance (physician
Health Care Evolution
Health Care Evolution Patient-Centered Medical Home to Clinical Integration & Accountable Care Ken Bertka, MD bertka@mindspring.com 419-346-8719 Agenda Top 3 Challenges of Health Care Reform PCMH & ACO
Introducing Superior HealthPlan s Medicare Advantage (HMO) Plan SHP_ H
Introducing Superior HealthPlan s Medicare Advantage (HMO) Plan SHP_20163759H Healthy Partnerships are our Specialty. At Superior HealthPlan, we are dedicated to creating the best health-care plans for
Self-Insured Schools of California: Schools Helping Schools
Self-Insured Schools of California: Schools Helping Schools Blue Shield of California Access+ HMO Plan 2016/2017 Enrollment Guide Blue Shield of California offers health benefits to school districts that
Outline of Medicare Supplement Coverage Cover Page: Benefit Plans Medicare Supplement Core Through Choice
Outline of Medicare Supplement Coverage Cover Page: Benefit Plans Medicare Supplement Core Through The chart on the following page shows the benefits included in each Medicare Supplement Insurance plan.
Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your Network: California Care HMO
Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your : California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary
Classic Plan (HMO-POS) Value Plan (HMO) Rewards Plan (HMO)
January 1, 2016 December 31, 2016 Classic Plan Value Plan Rewards Plan SECTION I INTRODUCTION This booklet gives you a summary of what we cover and what you pay. It doesn't list every service that we cover
Consumer Survey Results
Consumer Survey Results Greater Area Health Council Survey Round Two Under the direction of The Aligning Forces for Quality (AF4Q) Evaluation Team Dennis Scanlon, Ph.D. May 2013 The survey and data analysis
Executive, Legislative & Regulatory 2018 AGENDA. unitypoint.org/govaffairs
Executive, Legislative & Regulatory 2018 AGENDA unitypoint.org/govaffairs Dear Policy Makers and Community Stakeholders, In the midst of tumultuous times, we bring you our 2018 State Legislative Agenda.
Medical Plans Benefit Guide
Medical Plans Benefit Guide Employers with 1-50 employees 1.1.01 Provider network built for value and quality... Wellness rewards...3 Medical Travel Support and Air or Surface Transportation... Support
CareFirst BlueChoice. District of Columbia
CareFirst BlueChoice District of Columbia Welcome We are pleased to offer you enrollment in our CareFirst BlueChoice Health Maintenance Organization (HMO) plan. Designed for today s health conscious and
Choice PPO Retired Employees Health Program Non-Medicare Eligible Retired Members
Choice PPO Retired Employees Health Program Non-Medicare Eligible Retired Members DEDUCTIBLE (per calendar year) Annual in-network deductible must be paid first for the following services: Imaging, hospital
Direct Care Deductible 2000 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond
Direct Care Deductible 2000 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond The Fallon difference Direct Care is a Limited Provider Network. With Direct Care Deductible 2000 Hybrid,
Integrated Leadership for Hospitals and Health Systems: Principles for Success
Integrated Leadership for Hospitals and Health Systems: Principles for Success In the current healthcare environment, there are many forces, both internal and external, that require some physicians and
2018 CareOregon Advantage Plus (HMO-POS SNP) Summary of Benefits
2018 CareOregon Advantage Plus (HMO-POS SNP) Summary of Benefits For Oregon counties: Clackamas, Clatsop, Columbia, Jackson, Josephine, Multnomah, Tillamook, Washington and Yamhill H5859_1099_CO_1018 CMS
Staff Training. Understanding Healthix Patient Consent
Staff Training Understanding Healthix Patient Consent Healthix Facilitates Exchange of Data Healthix Policy and Patient Consent Work Responsibilities: Training, Documenting and Preparing for Audit 1. Let
Summary Of Benefits January 1, December 31, 2014 Optima Medicare Optima Medicare Basic HMO Optima Medicare Enhanced HMO
Summary Of Benefits January 1, 2014 - December 31, 2014 Optima Medicare Optima Medicare Basic HMO Optima Medicare Enhanced HMO www.optimahealth.com/medicare Table of Contents 3 Letter from Michael Dudley,
Chapter 4 Health Care Management Unit 5: Quality Management
Chapter 4 Health Care Management Unit 5: Quality Management In This Unit Topic See Page Unit 5: Quality Management Quality Management Program 2 Prevention and Wellness 4 Clinical Quality 5 Network Quality
PBM SOLUTIONS FOR PATIENTS AND PAYERS
PBM SOLUTIONS FOR PATIENTS AND PAYERS Reducing Prescription Drug Costs Designing Solutions for Employers, Unions, and Government Programs Delivering High Patient Satisfaction and Improved Outcomes Improving
Overview of Select Health Provisions FY 2015 Administration Budget Proposal
Overview of Select Health Provisions FY 2015 Administration Budget Proposal On March 4, 2014, President Obama released his Administration s FY 2015 budget proposal to Congress. The budget contains a number
The presenter has owns Kelly Willenberg, LLC in relation to this educational activity.
Kelly M Willenberg, MBA, BSN, CCRP, CHC, CHRC 1 The presenter has owns Kelly Willenberg, LLC in relation to this educational activity. 2 1 Medical Necessity when you submit claims Coding for qualifying
This plan is pending regulatory approval.
Bronze Full PPO 3000 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective October 1, 2015 THIS MATRIX IS INTENDED TO BE USED
Select Care Deductible 1200 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond
Select Care Deductible 1200 Hybrid Benefit Summary Benefits effective January 1, 2018 and beyond The Fallon difference With Select Care Deductible 1200 Hybrid, you get everything you need to live a healthy
Draft Covered California Delivery Reform Contract Provisions Comments Welcome and Encouraged
TO: FROM: RE: State Based Marketplaces State Medicaid Directors Delivery Reform/Value Promoting Colleagues Peter V. Lee, Executive Director Draft Covered California Delivery Reform Contract Provisions
PROPOSED MEANINGFUL USE STAGE 2 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY
PROPOSED MEANINGFUL USE STAGE 2 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY On February 23, the Centers for Medicare & Medicaid Services (CMS) posted the much anticipated proposed
A Prescription for the Free-Standing ED. Kimberly Nealon, St. Vincent Health; Steve Mombach, TriHealth; John Marshall, BremnerDuke Healthcare
A Prescription for the Free-Standing ED Kimberly Nealon, St. Vincent Health; Steve Mombach, TriHealth; John Marshall, BremnerDuke Healthcare Agenda I. Introductions: Kim, Steve, John II. III. IV. Market
Kaiser Permanente QUALITY OVERVIEW OVERALL RATING : 3.4 COMPANY AT A GLANCE. Company Statistics. Accreditation Exchange Product
QUALITY OVERVIEW Permanente As the state s largest nonprofit health plan, Permanente is committed to improving the health of our members and our state as a whole. Permanente is made up of: Foundation Hospitals
Ten Things to Know About Your Activate Health & Wellness Center. 10Serving. Elkhart Community Schools
Ten Things to Know About Your Activate Health & Wellness Center 10Serving Elkhart Community Schools 1 Your Activate Health & Wellness Center FOR MORE DETAILS: activatehealthcare.com/elkhartcommunityschools
Your Plan Explained. MetLife. UnitedHealthcare Group Medicare Advantage (PPO) Group Number: 12359
2016 Your Plan Explained MetLife UnitedHealthcare Group Medicare Advantage (PPO) Effective: January 1, 2016 through December 31, 2016 Group Number: 12359 Benefit highlights MetLife 12359 Effective January
Colorado Choice Health Plans
Quality Overview Health Plans Accreditation Exchange Product Accrediting Organization: Accreditation Status: URAC Health Plan Accreditation (Marketplace ) Full Full: Organization demonstrates full compliance
High Deductible Health Plan (HDHP)
High Deductible Health Plan (HDHP) BeneFIts Summary Effective July 1, 2012 or October 1, 2012 Benefit Highlights How The Plan Works...1 Summary Of Benefits...4 Special Programs...7 Approval Of Care At
Frequently Discussed Topics
Frequently Discussed Topics L.A. Care Health Plan Please read carefully. What are Copayments (Other Charges)? Aside from the monthly premium, you may be responsible for paying a charge when you receive