The Management Services Organization that leads Physicians Direct Access (PDA) IPA is proud to announce the inculcation of PDA within the Scott & White Health Plan (SWHP) network. It is great that we are contracted with this growing network!
This major achievement began in January with meetings including the senior marketing and network operations executives of SWHP and the insurance sales agency of The Miers Group and the MSO serving PDA. The plan was to both produce meaningful benefits plan sales for the new SWHP product and also to be a mobile, in-touch provider network component for SWHP. The network component intends to coordinate with SWHP merger and acquisition needs and practitioner network completeness. It was understood that PDA will make every effort will be to coordinate and support perfection of the narrow network product. The MSO recognizes the importance of educating PDA providers to grasp the concepts of a narrow network as preparation for “pay-for-performance” is underway. Our agency component has similar challenges with presentation and education of narrow network benefits to prospective and existing customers.
It is intended that the PDA physicians participating in SWHP will begin loading into their IT system after the first of September. As this is completed, the MSO will communicate closure to the participating PDA practitioners. Also, narrow network rules and regulations, etc., will be an ongoing IPA education effort. The PDA group will have delegated credentialing privileges and the ability to add new practitioners to SWHP as is appropriate. That is a major achievement in speed of operation.
Currently, the IPA is recruiting members from new community areas containing independent practitioners. For an example, the Walnut Hill Hospital medical staff is being introduced to PDA and the new and existing 2016 managed care portfolio. This is an exciting opportunity to build new relationships.
There will be delays and administration stoppages, but PDA, your IPA, is a growing business with one of the most important patient distribution systems of North Texas. It is believed that with Aetna, Blue Cross, Humana, SWHP, United, Universal American, etc., and all the creative self-insurance plans being sold are seeking an IPA that “Gets It!” and that is the MSO’s mission.
PDA is preparing for “Pay For Performance” and “Population Health Management”.