The Health Partner: What Self-insured Employers Need to Know [Infographic]

Care guides can play a vital part in keeping healthcare costs down, and MissionPoint takes them to the next level with its Health Partners. Health Partners are care guides that work one-on-one with high-cost, high-risk medical plan members to help lower costs. This unique partnership can translate into less money spent on healthcare, while members get added services to help them stay well, ultimately helping both a self-insured employer’s bottom line and its associates’ well-being. Health Partners are not utilization managers – they are nurses, social workers, and other health experts who work directly with members as an extension of physicians (they don’t just make phone calls from remote locations). They connect members to local resources and remove the barriers… read more

Diseases of life: Life situations act as barriers to care

Healthcare today has become disease-centric. We not only focus heavily on the biomedical needs of our patients, but we do it from a disease-defining perspective. We have pathways and guidelines that are disease specific, we have specialty clinics that are disease specific, and our treatments are very focused on treating a disease. Working from this disease-based paradigm has caused us to even view those we serve through this disease lens. You hear the words “my diabetic patient,” or “my heart failure patient.” This perspective causes issues for many reasons. First and foremost, those we serve do not view themselves that way. Our patients view themselves as human beings that happen to have a disease or illness. Second, rarely does a… read more

Monthly management payment models can improve access and care with incentives

As we move to value-based models of care, the role of the primary care physician will play a greater role in managing the overall care of their patients instead of just getting paid to see them. Incentives have always been a positive way to increase a desired effect. Under value-based models, paying a monthly management fee to primary care physicians has been a payment model that has gained strength over the years. However, many detractors to such a model have argued that paying a monthly management fee reduces the incentive for providers to provide access and care. In order to offset this possible occurrence, MissionPoint Health Partners added further incentives to increase access and provide certain types of care. These… read more

ACOs far from the HMOs of the ’90s

Today’s Accountable Care Organizations (ACOs) are quite different than the Health Maintenance Organizations (HMOs) of the ’80s and ’90s. HMOs effectively controlled costs, which plan sponsors liked. But their “narrow networks” were unpopular among healthcare consumers because they functionally prohibited seeing providers who were not part of the HMO. Americans value consumer choice and don’t take kindly to it being denied. Today’s ACO, an innovation of recent years in health plan management, incentivizes the health plan member to see providers in the network. Among providers within the ACO network there is a very high level of care coordination. But the ACO does not prohibit members from seeing providers outside the network. Additionally, technological advances since the heyday of the HMO… read more

Accountable Care Organizations [Infographic]

Accountable Care Organizations (ACOs) are the latest population health management model. If you’re still in the dark about ACOs, we’ve put together a handy guide to understanding how they work. The ACO model can improve care quality while also lowering costs, improving value for its members. To do this, ACOs reward outcomes instead of output, so healthcare providers get paid more when the people they care for do well. Accountable Care Organizations are networks of facilities and healthcare providers with a core of primary care physicians that work together with qualified care guides to provide holistic care. MissionPoint calls its care guides Health Partners, who are registered nurses that help guide Members through health and life challenges to achieve more… read more