Overview for Patient Care Network of Mississippi

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Presentation transcript:

Overview for Patient Care Network of Mississippi Melisa Hinders, BA, BSN Staff Vice President, Network Development Government Business Division

Our Experience The Anthem family of health plans has 25 years of experience providing care management and coordination for state-sponsored health programs that span 20 states.

Our Value Proposition Medicaid Value Proposition Manage costs, both medical and administrative Medicaid Value Proposition Improve clinical outcomes and access to care Provide a satisfying customer service experience Thought leadership

Industry Movement Quality and Value are Fundamentally Important Performance We Firmly Believe Reduce the Cost of Care trend Improve Quality results Improve Overall System Performance Time

How We Help Facilitating stronger relationships between doctors and patients for better preventative care Aligning incentives for better-quality, lower-cost care, and finding smarter alternatives to the fee-for-service system Working with doctors to choose the partnership model that works best for them, whether that’s value-based payments, shared savings, shared risk or even a co-created product or joint venture Supporting doctors and employers as they navigate the health care system. Giving doctors access to data that offers a full picture of their patients’ health — and helps them provide better care and close care gaps more quickly Streamlining the health care experience, and making it easier for members to access the care they need.

Partnership with Providers is Key Our Partnership Model Iterative Support Structure – Collaborative Approach & Continuous Improvement

Driving Value Based Care

Additional Partnership and Collaboration Opportunities Behavioral Health (BH) / Physical Health (PH) Integration Rural Access Expansion Effective Use of Physician Extenders Expand Telemedicine

Additional Partnership and Collaboration Opportunities BH / PH integration Potential opportunities for collaboration Co-location of BH providers in FQHCs Collaboration between FQHC’s and CMHCs to coordinate continuum of BH / PH care (similar populations / safety-net providers) Potential Challenges Practice re-alignment Data integration

Additional Partnership and Collaboration Opportunities Expansion of rural access Potential opportunities for collaboration Satellite locations/SBHCs staffed by physician extenders aligned with FQHC Telemedicine Expansion of FQHC presentation sites for specialty consults Remote and after hours primary care / home-based care supports Potential Challenges FQHC adoption of technology solutions FQHC reimbursement methodology

Questions?