PDA is supporting community-based healthcare to improve the wellness, productivity, and quality of life of DFW workers and their families. This must be done while controlling healthcare costs. The campaign requires a great core hospital, surrounding ancillary services, and the best of PDA/IPA practitioners. Also it is important to channel trustworthy, correct healthcare information to the individuals who can make positive change occur in their personal lives along with their employees and dependents.
The first phase of this strategy is now being launched in the counties of Dallas, Rockwall, Collin, Hunt, and Kaufman, specifically in the areas surrounding Lake Ray Hubbard. Today, the Flagship Healthcare Network is seeking talent in the area of sales and service for benefit plans. The market, composed of small businesses (25-250 employees), will soon require a direct contract marketer with the skill needed for benefit plan sales and for caring service after plan implementation. A Texas Department of Insurance license for General Lines and/or an Insurance Counselors License is required. Lack of a license can be easily remedied by a brief course of study and successful exam.
The Flagship Network is also immediately seeking a person to assist physicians in applying for PDA membership and Network participation. This is an important position that places our employee in contact with the practitioners and their office staff. We will equip you with a comprehensive knowledge of the Flagship business model and how it benefits patients and practitioners. The primary requirement is genuine passion to make the Flagship successful for the benefit of the participating patients and caregivers.
Referrals are requested. The PDA nation is definitely the best source of referrals. Thanks!
Two major changes are rolling toward American physicians. The first of these is a Congress-approved 27% cut in Medicare reimbursements. We cling to the hope that Congress will once again back away from these cuts, but considering the dysfunctional behavior of our elected representatives in Washington, no one can predict what the outcome will be. Second, President Obama has promised us a flood of 40 million new patients with government-subsidized insurance. And likewise, nobody can say if this promise will be fulfilled or how reimbursement will fare.
Facing these threats, many physicians feel pushed to abandon Medicare entirely. That is certainly an option with great complexity and possible long term issues. Physicians wanting help with implementation of a “Medicare Shut-Down” are welcome to discuss the process and risk with PDA management. Walking away is not a simple thing.
Another option is to learn how to profit from Medicare in the “New Normal”. It can be done and is being done throughout our state. The patient care system of managed Medicare is very possibly the template for the future and for commercial insurance as well. Our focused discussions and literary reviews seem to indicate that a cost effective, high quality care system must be better coordinated and managed. Chronic/transitional care has a place in a “medical neighborhood”. Wellness and behavior support may be the grid of the medical district for “frequent fliers” seeking only episodic or urgent care. This concept of a community that is working to be more healthy and vibrant is potentially powerful and can be embraced by the senior patient.
PDA has established a working alliance with a major Medicare Advantage insurer, Universal American (UAM/NYSE). PDA competed successfully to become UAM’s primary “go-to IPA”. UAM was identified from the rankings of Wall Street financial analysts and by physicians in other cities. We have shared ideas while analyzing their benefit models. Now, we are committed, with UAM, to building an alternative for PDA physicians so that we can actually be compensated for quality of care rather than simply for volume of care. So, our patients can find new levels of coordinated care and well being.
In the 1990s, the term “HMO” began to generate negative sentiments because cost savings depended on withholding or limiting care. Today, we are dedicated to learning how to measure quality. And more important, we know how to compensate physicians for quality rather than for withholding care. Implementation of best practices and constructive medical management can allow physicians to maintain and perhaps even prosper in a Medicare Advantage environment. PDA invites you to join in our quest.
Physicians, Nurse Practitioners, Physician Assistants and all caregivers work long, hard hours. It is difficult for them to step back and think about where their career is headed. There is always another patient to see, and planning will wait for another day.
Still, it is so important to consider one’s situation before starting the next to-do list. Business executives use a proven tool kit called a situation analysis. The process is best known by the acronym SWOT which stands for “strengths, weaknesses, opportunities and threats”. The process is intended to create a distilled summary of “factors critical to success”. Those factors provide a basis for strategically planning what can really make a big difference in income, reduced hassle and work time. SWOT is a sound investment in time for the individual practitioner. If you would like to work through a SWOT analysis, PDA managers will gladly help you customize a personal statement. PDA not only routinely works through a situation analysis for the IPA but also makes sure that the result is continually updated. The process is a joint effort between physicians and managers. Breaking down the SWOT analysis:
- Strengths is an inventory of advantages that are yours to control. An example could be that the practice performs successfully with a “gain-sharing” Medicare Advantage company. Another example might be a strong source of patient referrals. Maximized positives should drive the practice to new profitability and improved patient outcomes.
- Weaknesses are also yours to deal with, and they need corrective action plans. Self-analysis of areas for improvement is a difficult yet important process. This analysis also funnels into “factors critical to success”.
- Opportunities in the practice environment are potential avenues for improving service, income and life style. But, the big feature associated with identifying opportunities is that these are limited to things that are beyond one’s direct control. For example, the malaise over “ObamaCare” is a reality beyond the control of the practitioner. Still, there are genuine opportunities for success that are imbedded in this change.
- Threats are also environmental realities that need to be recognized and considered.
For example, a financial crash in Europe could cause a double dip recession in the U.S. A PDA physician can do little to impact that threat, but is well served to think about how such an event might cause practice and lifestyle to change. That thinking can lead to financial contingency plans.
A thoughtful review of the SWOT analysis can allow focus on “factors critical to success”. And, that is what we should be concentrating on with all the energy that can be mustered. This blog just scratches the surface on a real necessity for PDA practitioners to plan. If you need some assistance, let us hear from you. Planning is essential to victory! We are here to help.