RaeAnn Grossman.

Physician Engagement… What can you really do?

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Health plans have tried a hundred ways to engage providers – incentive stipends, P4P, P4Q, capitation, clinical initiatives, episode of care payment, onsite coders, in office case management liaisons. But what works?  Open communication, reasonable expectations, and simplicity.

Before CenseoHealth launches a patient evaluation program we meet with the community physicians to discuss:
1. Program Overview
2. Program Goals & Objectives
3. Community Customization & Clinical Opportunities
     a. What are you doing well?
     b. What do you need help with?

Often Censeo receives questions similar to those that follow:
• What are you doing with my patients?
• What can you really diagnose in the home?
• What do I receive from the Censeo clinical team?
• What if I want to participate?

Again, CenseoHealth shares the following:
• Program from launch to closure
• JAMA articles and clinical research & guidelines utilized in the Censeo programs
• Proprietary iPad tool and outputs for the evaluation
• Open Invitation to participate whether conducted in the office or home

As your internal metrics may highlight, between 8% and 30% of the membership may go to the physician’s office for an evaluation, if encouraged. If the network physician has the same tool and the same time allotted for the visit, the outcome can be just as successful. However, if the physician’s time is limited, the data collected is also limited. The averages results for an in-office evaluation completed in 25 minutes are approximately 1/3 of the information collected during an in-home evaluation; therefore the premium impact in the office is about 1/3 of the in-home impact.
How does CenseoHealth counter act the lower in-office results?

• invite the community physician to utilize the proprietary tool via iPad or paper
• educate network physicians on the HEDIS, STARs, HCCs, compliance, and accurate coding
• schedule in-office visits for the medical group to ensure the needed time is allocated for the experience
• completed quality assurance, coding, and analytics for the medical groups
• meet with both the health plan and medical to review reports and programs successes

We make your network part of the team and solution. Physicians are great team members when they are invited, respected, and given the premier instrument for success.

RaeAnn Grossman.

About RaeAnn Grossman.

RaeAnn Grossman is one of the nation’s foremost experts on risk adjustment strategies and provider and payer alliance configurations, along with healthcare business and product development. She brings Gorman Health Group more than twenty years of professional experience in a wide variety of healthcare organizations including Health Plans, Medical Groups, Physician Hospital Organizations (PHOs), Integrated Hospital Systems, and Institute of Health Professionals Education. Read more

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