There are five companies in the spot light…with more taking focus. Business owners/managers are working with their agents to consider self-insurance. And, the agents are turning to ask the Flagship’s General Agency, The Group Warehouse of Texas, to seek quotes for self-insured Narrow Network services. These quotes are provided by third party administrators and re-insurance insurers. As self-funded programs compete successfully with the Federal Affordable Healthcare program and offer the opportunity for managerial flexibility with the possibility of saving big dollars, the market acceptance is growing rapidly. That means the first Flagship sales are near. This calls for preliminary preparation steps:
* Identification of possible physicians that will serve as a COMPANY PHYSICIAN [This the major high-profile, up-front need. As the Flagship begins operation… the compensation, challenges and availability of the Company Physician is important business ]
* Readying of the Biometric testing program
* Telemedicine ramp-up
* On-call bi-lingual worker assistance for the open-enrollment period
* Notification of the new customer’s identity and special interests
* Schematic for Flagship patient referral
More to come from the Flagship Medical Director.
Phone 972-484-5889 Fax 866-230-7104 Email: firstname.lastname@example.org
PDA is an independent physicians association that strives to generate new revenues for its practitioners, eliminate hassles, and not require any more time. The organization contracts with commercial managed care payers, Medicare Advantage Programs, and Medicaid opportunities. Current new business development is directed at Employee Retirement Income Security Act (ERISA) contracts, i.e., Direct Contracts to employers and Department of Defense healthcare programs. Day-to-day operations issues at the physicians’ offices relating to managed care are supported by PDA resources. PDA colleagues provide medical marketing to grow practice revenues and profitability, full service insurance benefits including medical malpractice, and healthcare operations management. The Chairman and Board of Directors are independent physicians. Bylaws equally include nurse practitioners, physician assistants, nurse anesthetists, podiatrists, and other allied health professionals. Through various marketing and contractual agreements, PDA is engaged with 780 practitioners in seventeen counties.
The Flagship Physician Network is very important to independent physicians. Physicians work so hard and are completely focused on their patients & practice. As a result, they may not know about the ground–level change rolling out of the Patient Protection & Affordable Care Act (PPACA). PDA/the IPA is intently endeavoring to track the changes as the October 1st milestones fall. The staff is following the reading reference sources of Modern Healthcare, The National Association of Underwriters, Physician Journals, Human Resource periodicals, Texas Department of Insurance, various blogs, and the HHS “Pro-ObamaCare” informational & enlistment publications. And, those changes happen daily. Even though tracking the PPACA is like watching a hurricane, i.e., it just keeps coming and it has a life of its own, the IPA catches most of the information.
Covered up in all this news and noise are important messages. For example, an important central message is that there is an over-riding pressure to sign-up healthy uninsured individuals at the lowest subsidy. That will either make the PPACA work, or failure to accomplish this goal may bring down the program. We also have three lawyers that are expert in the law and are available for plan consultation.
There is misinformation, propaganda and very slick marketing being distributed through the media to tell the USA what is either good or bad depending on one’s ideology and bias. There is just so much noise! But, one thing that physicians need to know is that this hurried unfurling of plans, honor-system subsidies, and pricing will generally mean less inclusion in provider panels and networks with downward reimbursement price pressure on the providers. For the patient, it is going to mean difficulty in seeing the top physicians, difficult plan selection decisions, and risks associated with being “navigated” by others into exchange based coverage.
What can you do? Physicians need to look at their practice, and consider convincing business operators, owners, and patients that they should investigate self-insurance. The concept of physician and patient working to create a system of self-control and self-funding is perhaps one of the best ways out of this messy confusion. Who better than local physicians and their IPA to solve this national issue? Businesses with ten or more workers and generally average health situations must look closely at how they can effectively self-insure and work with their community hospital and physicians.
Setting expectation is very important. The Flagship Network is new and just beginning to sell in the community, but it is a great option for the independent practitioner. It serves the self-insured employer of ten to 250+ workers. It has flexibility to satisfy the governmental templates and requirements, but it also may save the customer/patient money while reimbursing the practitioner, outpatient service, and hospital in a reasonable manner. The “Narrow Network” model of the Flagship is one with a limited number of physicians and a strong community centered approach to care delivery. That entire model is surrounded by a national network of other providers who care for out-of-area medical needs.
Physicians are in the community today explaining Flagship strength and self-determination. Will you help us? Would you put your shoulder to the wheel? Call 972-484-5888.
Call PDA for a personal explanation. This is where the IPA lives. The Flagship is sailing. All aboard! Next stop is a clinically integrated organization for independent physicians.