The main theme of 2014 Blog series is how the Flagship product works and what is incorporated in the program for advancement of your interests. As independent physicians, the PDA/IPA membership is seeking such answers regarding how to make more money, avoid hassle, and not have to work longer hours. The IPA leadership maintains that being a stakeholder in the Flagship Physician Network (FPN) is crucial to achieving that goal. There is a major difference with a Company that welcomes stakeholders and one that views the practitioner as no more than direct labor component.
There is a major negotiation underway that impacts every independent physician in DFW that has expectations of “The Flagship Physician Network”. The Flagship is approaching a decision on affiliating with a “National Network” of diverse providers, i.e., inpatient, outpatient, practitioners, clinicians and healthcare services. The current Narrow Network of acute care, outpatient and medical practitioners will be “the epicenter” of this comprehensive national overlay of patient care. This is a major undertaking that has been evolving for over a year. It is at the “Letter of Agreement” stage. You will be informed at each stage of completion.
This opens up a major new approach of positively reimbursed networking to market the Flagship self-funded products. Brokers can provide the “Branded” program across the State of Texas! And, participating Flagship card holding persons can seek medical care anywhere in the USA. So, it is close to being a new level of business delivery.
It is important to point out that this year the product is a robust self-funded offering. Soon, the program will evolve to cooperate with clinically integrated organizations and the steady march to “outcome based” reimbursement versus units of service.
Please call 972-484-5888 and ask for information to enlist in the Flagship Physician Network. Also, specialists and primary care physicians are requested to indicate interest in serving as a “Company Physician” and as a Medical Management leader. It is show time for the Flagship!
The message is so strong; it needs to be said again and with emphasis. The foundation of the Flagship Physician Network is Physicians Direct Access (PDA), an independent practitioner association (IPA). There is no bargain in physician representation in DFW equal to PDA’s value proposition. The high-points of the value proposition accrue from:
· The cost for managed care representation is dramatically less than the competition. PDA has figured out a membership charge that has truly no mark-up. This is to produce twelve months of service that is equal to an office self-representing its services. The savings when applied to years of PDA affiliation creates a major savings against any competition. Today, cost is a universal concern for everyone.
· The IPA holds forty plus contracts with managed care, Medicare Advantage and the Flagship Direct Community Product. These contracts provide a real-time reference base for understanding current trends and situations in physician compensation. Also, the IPA is working with a major hospital company to develop a clinically integrated organization that would, in certain circumstance aggressively negotiate past the limits imposed on a messenger model IPA. Yes! An advocate, guard, and provider of services for the cost of a daily cup of coffee!
· The IPA has access to the only proprietary self-insured product that invites practitioners to seek new revenue streams such as the Company Doctor, telemedicine participation, biometrics, etc.
· A pay-for-performance PCP model is in place and results will soon be public.
The “invitation” is very simple. This implies no negativity for managed care or any other player in the topsy-turvy healthcare space. The message is to look at PDA. Sort out the real value; think about how to work with the IPA to make more money with less regulation and no more sweat. The leadership of PDA knows that the traditional IPA is a key component of managed care’s fee-for-service directing of patients. But, it is also clear that the independent physician has to have the opportunity for improved profit margins through performance. And, that is PDA’s business. Plus, the FPN is providing a glimmer of something potentially bigger and better. Join the Flagship now, and talk to the FPN physician leaders and learn more about this local solution for a national problem. Actually, it an exciting proposal! We should have 2,500 members in 2014-15.
Flagship Physician Network (FPN) Continuing Instructional Blog
The main theme of 2014 Blog series is how the Flagship product works and what is incorporated in the program for advancement of your interests. As independent physicians, the PDA/IPA membership is seeking such answers regarding how to make more money, avoid hassle, and not have to work longer hours. The IPA leadership maintains that being a stakeholder in the Flagship Physician Network (FPN) is crucial to achieving that goal. There is a major difference between a Company that welcomes stakeholders and one that views the practitioner as no more than direct labor component.
Here is the friction, if Physicians are just direct labor and are only productive cogs in the big wheel of patient care, the PDA core objective of more income and less stuff is irrelevant and one has no need for a financial advocate. The difference is the physicians have to a leadership that shows how to improve outcomes and productivity, with an understandable, transparent, and attainable potential for equitable new rewards, i.e., “Do better and get a piece of the action.” That is us!
Everyone is for that. Where does the game begin? It starts with the coin of the realm, bitcoin, double eagle gold coins, etc. which in paying for healthcare is “PER-EMPLOYEE-PER-MONTH or in an abbreviated form…PEPM. This stands for dollars allocated to pay for healthcare in the context of “per-an employee-on a monthly basis”. This is actuarially arrived at usually in a manner that is adjusted for age, sex, and medical claims history, etc. For example, an insurance company may decide that a population of workers housed by an employer in a specific industry with a definite history/pattern of claims may be insurable for “X$ PEPM”. That is a rough-cut example but it gets the idea over that insurance companies routinely decide what the PEPM should be and allocate their budgeted PEPM over hospitals, physicians, etc. Then, this financial and statistical conglomeration manifests into a master contract that seeps down to the IPA level. The IPA usually can do nothing but serve as the credentialing and administrative messenger to their represented individual physicians. This sets up a time when the IPA member physician is told that the proposed managed care agreement pays Medicare plus five percent for each contract approved CPT code. This all based on the PEPM factor.
It does not take a rocket scientist to grasp that PDA must get to the place that it can control and/or influence the PEPM! The FPN offers just this potential. That is so important. The FPN is a proprietary product that is based on PDA practitioners. There are physicians who are seeking licenses to market the product to their friends and patients that own and operate businesses. The FPN and PDA have a significant shared potential. And, that future will be linked to understanding PEPM.
1. Are you signed up as a Flagship contract participant with PDA?
2. Have you stepped up and let the Flagship know that you would like more information on “The Company Physician” program?
3. Has the licensure requirement to sell the Flagship product been explained to you?
4. Does an investment position with the Flagship Management Services Team interest you?
The main theme of the 2014 Blog series is how the Flagship product works for the advancement of your interests. As independent physicians, the PDA/IPA membership is seeking answers regarding making more money, avoiding hassle, and not having to work longer hours. Let’s focus on how the Flagship Physician Network (FPN) compensates practitioner members who are invited to participate.
The foundation of the Flagship is Physicians Direct Access (PDA), an independent practitioner association (IPA). There is no bargain in physician representation in DFW equal to PDA’s value proposition. The IPA holds thirty plus contracts with managed care, Medicare Advantage and the Flagship Direct Community Product. These contracts provide a real-time reference base. This factual database of reimbursement provides a grid creating a fee schedule for so that the PCP will be paid at the highest range of managed care rates. This is critical for PCPs because they are being acquired at a rapid rate and in doing so are surrendering their independent status. The loss of a robust independent PCP cadre brings the entire issue of referral patterns to specialists into discussion. Meanwhile, DFW specialists are being courted by a variety of organizations in a pay to play scenario for panels that compete for referrals by underpricing their services and by imposing defined “best practice” methods on the PCPs. Again, PDA is not critical of this change; it is just not the IPA’s selection for the future. Participation in “clinically integrated organizations” is in fact supported. PDA is committed to a multifaceted strategy that is believed to be best for the independent physician’s economic and professional needs.
For specialists, the Flagship has created a fee-for-service schedule better than most managed care contracts and one which supports independence. Also, joining the FPN is at no additional cost if one is a PDA/IPA participant. The deliverable is a top-level pay potential in all managed care contracts plus support of a non-insurance product that drives new business through direct contracting. That is hard to beat. Seriously, this is without known competition.
The “invitation” is very simple. To be an effective FPN provider, the practitioner should understand what makes up an ERISA based self-insured product. The office manager and physician must have a grasp of the difference in serving a traditional PPO contract, Medicare, Medicaid, etc.…VERSUS a direct contract with a community business that is relying on the physician. This implies no negativity or “bad-mouthing” for managed care. Rather, the IPA is a key integrated component of managed care’s fee-for-service directing of patients. What the FPN is providing is a glimmer of something potentially bigger and better. The FPN is a community-based re-envisioning of how to fund non-government controlled healthcare. Talk to the FPN physician leaders and learn more about this local solution for a national problem.