Open Invitation to Receive New Commercially Insured Patients
“Flagship Network Adequacy”
Managed care companies have long spoken to the need for “network adequacy”. This term primarily relates to the number of PCPs and specialists serving a specific geographic area. A patient should be able to access a PCP in twenty five minutes and reach emergency care in the same time frame. One can debate the time variable for special situations, but the 25 minute estimate represents a guideline for both need and convenience. Add in practitioner capacity and customer service, and true network adequacy begins to take shape.
In addition to the physician panel, a number of other aspects of network adequacy must be considered. First, the core hospital must be essentially full-service with at least a level four trauma center supported by helicopter transport. Diverse outpatient services are necessary and should be coordinated by the physicians and discharge planners. In short, the center piece hospital and its outpatient services must be fully responsive to the community’s requirements with fast referral capability to area tertiary care institutions. Surrounding this core is a ring of transitional care, wellness, rehabilitation, home care, hospice and other supportive services. At the periphery is a necessary secondary network to care for patients who are physically beyond the Flagship service area. All these resources combine to halt out-migration from the local community network. This defines vertically integrated network adequacy…our Flagship ecosystem.
Network adequacy must include a balance between participating providers and patient volume. If provider participation is limited and inadequate, the resulting long wait times and stressed office staffs will lead to both patient and provider dissatisfaction. On the other hand, too many providers relative to patient traffic will result in disengaged providers. Flagship physician leaders will work hard to ensure a balance of practitioners equal to patient need.
By all criteria, the Flagship is approaching network adequacy in both primary care and the specialties. The message is clear. With marketing about to begin, all physicians wishing to participate should complete the enrollment materials as soon as possible. Sales in the community begin in days. You will profit as a committed team member of the Flagship “Narrow Network” exclusive provider organization.
The Flagship “Narrow Network” has quietly opened a new brand of healthcare in the DFW marketplace. With the Lake Pointe Healthcare Network (LPHN) and an energized physician cadre, the Flagship was conceptually launched a year ago. Initially, the community based network opened provider enlistment in the five county area surrounding Rockwall and Rowlett. The plan was to build LPHN on the Physician Direct Access IPA platform and link the provider team to the TMG Benefits consulting services.
With a robust core of primary care leaders and a group of specialists able to compete with any in Dallas, the first network is near completion. The hundred and fifty physicians, nurse practitioners, and physician assistants have joined forces to provide special community based care.
This is a dynamic ecosystem of balanced care which includes telemedicine, the “Company Physician” concept, transitional care, and a surrounding ring of physicians for out-of-network needs. Relationships exist that propagate quality care, slow out-of-area patient migration to downtown options, and bring new coverage to the 40% of employed workers who are currently uninsured. Everyone is benefited by local care.
The target is the cohort of small businesses with 25 to 250 workers. These are the backbone demographic of “the American Workforce”. This is where many uninsured but gainfully employed people function. Here resides the specter of possible major illness with the associated lost productivity and devastating financial implications. The Flagship Network will make a real difference! Yes, cost-effective quality care is coming to the Ray Hubbard area this summer!
With completion of the Lake Pointe Community Network, we are now beginning development of the Dallas White Rock Lake area including the rejuvenated and thriving Dallas uptown. Centered on Doctors Hospital, the next community based health system will reach out to the same market demographics. Then, the program rolls into Frisco with Centennial Hospital and its physicians.
Three million plus people await the Flagship solution in the Dallas area. There is much to do.