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Home > Resources > eNews > Jan 2000 |
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The Managed Care Insider eNews Volume Two Number 1 January 2000 PART ONE of TWO Welcome to The Managed Care Insider eNews. You are receiving this because you have subscribed; the eNews is never sent unsolicited. Subscribe/unsubscribe information can be found at the end of this eNews. The Managed Care Insider eNews is published, copyrighted, and owned by The Scheur Management Group, Inc. (SMG), http://www.scheur.com and is distributed monthly, free to subscribers. If you wish to forward this edition, you may do so only if the edition is forwarded in its entirety. No reproduction of any part of this publication is permitted without the express permission of the publishers. ---------------------------------------------------------------- This issue of The Managed Care Insider eNews reflects passion, opinion, and views related to physicians, hospitals, health plans and health care professionals working together to provide services and/or access to the best possible health care for consumers. Much has been written lately about "provider relations" and the inclusion vs. exclusion of physicians in the management of patient care. In this issue, Insider eNews focuses on what our new affiliate company, Venture Health Partnership Group (VHPG), is doing to reshape the practice of managed care with increased provider participation, and on a physician's view of the unrealized power physicians hold in managing care. We hope it provokes response, stimulates discussion and challenges change. As always, we welcome your comments to insider@scheur.com. ---------------------------------------------------------------- Insider Vision: The First Born By Barry S. Scheur President, Scheur Management Group and Chairman, Venture Health Partnership Group At the Scheur Management Group's recent annual meeting, we discussed our new business initiative, Venture Health Partnership Group (VHPG), and our business strategy of acquiring eight to twelve HMOs within the next twenty-four months and differentiating them through an orientation to the needs of local marketplaces and provider networks. In previous columns, I have portrayed VHPG's mission as "contrarian" in today's healthcare and financial marketplace. I hope you will feel free to share your thoughts on our venture. HMOs: A bad rap or the truth? Managed care has come to symbolize irresponsible, bureaucratic, non-customer-oriented or patient-focused health care, unfairness to providers, rigidity and bureaucracy to consumers, and short-term visions of profitability. Many of these perceptions of managed care are true; but it doesn't need to be that way. VHPG's greatest challenge is to create an organization in Louisiana that will serve as our template -- what I call the good healthcare template. Why does VHPG think we can succeed when others have failed? VHPG's vision, our objective, is to acquire distressed, provider-owned HMOs, rolling them up under a national umbrella while operating and marketing each entity locally. I believe we will be reshaping the practice, and the future, of managed care, focusing on providing high quality consumer-focused healthcare. We are becoming a new family, and with the acquisition of our first HMO finalized (SMA Health Plan in Louisiana), we have our first child. We will lavish love, affection and guidance on it, and watch it grow and prosper. We have the ability to differentiate VHPG from other investor-owned HMO companies. We can do this because our goal is not to generate the greatest amount of profit possible since that will, in effect, blunt the initiatives we need to put in place to reshape a broken industry. We anticipate that we will generate reasonable return while we create and implement a superior HMO template, one that attests to the concept that there is a provider and customer equation that works for people and that will bring the necessary return on investment. There is no question that we face economic challenges in effecting the turnaround of financially distressed, provider-owned HMOs. But many of these organizations are not broken medically; they are broken administratively. VHPG will succeed by doing the following: 1. VHPG-provider partnership. The provider network is the HMO's product. Its reputation is the HMO's reputation. VHPG pledges fair provider contracting, rewarding its partners who "get it" and participate as responsible partners. This doesn't mean there won't be disagreements with providers or issues related to provider reimbursement. We will provide information to providers and be responsive to their requests and needs. We will streamline bureaucratic processes and ensure accountability of our employees. This has been the hallmark of SMG as a consulting and operations management company since its inception. We will give providers the same stake in the provision of healthcare that they once had, and make it work under the new rules of the marketplace. 2. Customer-driven service. VHPG will put customer and provider satisfaction before everything else we do. We emphasize the objectives of the original HMO legislation. We plan to initiate customer services task forces, including physicians and hospital managers as our advisors. We will spend money on education, for both providers and members/customers. Information is power; education will enable members to receive the services they need and assist them in achieving and maintaining good health. 3. Local control and decentralization. Although VHPG is a national company, we are mindful of the perceptions of the local marketplace and respectful of them, culturally and operationally. Our HMOs will remain strong members of the community. VHPG does not plan to construct a large corporate infrastructure; each HMO will be a fully functional entity. We intend to support local decision-making. Medical management, provider relations, customer service, contracting -- the essential business functions -- will remain under local control and not be micro-managed corporately. We will outsource non-core business functions where we can identify partners with the requisite expertise, willing to take risk jointly with us. VHPG will expend its resources judiciously, purchasing from and offering value back to the community. 4. Fairness review process. VHPG will institute the nation's first external fairness decision review process with a respected group of bioethicists. We intend our decisions to be both medically and ethically appropriate. We will seek to assure our members and providers that all appeals will be reviewed by this outside ethics panel. This is another process to reshape the practice of managed care, the way it was meant to be. 5. Brand identity. VHPG is acquiring provider-owned HMOs where the identities of the HMO and the provider community are intertwined. VHPG will strengthen this identity. SMG has succeeded with bold (and sometimes controversial) advertising, spending money to communicate the HMO's message and brand identity repetitively. It is this brand equity that customers buy, reinforced by their perceptions and the (verbalized) experience of members. I believe passionately that community-oriented, locally marketed, and provider-friendly HMOs are the key to the resurgence of managed care. I am putting my money where my mouth is, and I will share our progress with Inside eNews readers. ---------------------------------------------------------------- What's New at SMG? ---------------------------------------------------------------- Up Close and Personal: Barry Scheur will be featured on MCO Executives. Interviewed by Greg Loughlin, Barry's views can be found on the MCO Executive site starting on January 10, 2000. To learn more, go to: http://www.mcoexecutives.com ---------------------------------------------------------------- SMG web site now offering access to amazon.com for all your book, audio, video, music and computing needs! ---------------------------------------------------------------- Upcoming Speaking Engagements: February 3, 2000 2000 Health Care Forecast Conference Graduate School of Management, University of California, Irvine TOPIC: "Providers and Managed Care: Remedy for a Sick Business" Speaker: Barry S. Scheur ---------------------------------------------------------------- Sites and Sounds on the Net: In keeping with our focus on relationships with physicians, providers, customers, we present some sites that offer tips, strategies and information related to improving all of these areas as well as healthcare sites which offer resources and research which may be useful to the healthcare practitioner. SMG takes no ownership of the following sites, nor does SMG endorse these sites which are presented solely as a resource for subscribers. In 1997, the US Government sponsored a consortium to study the best practices in customer service. To view the report, compiled by an impressive list of companies and people, go to http://www.npr.gov/library/papers/benchmrk/onestp.html The Atlanta Business Journal article on Customer Service from November, 1999, can be found at http://www.amcity.com/atlanta/stories/1999/11/01/smallb1.html A site with information and resources for MCO Executives at http://www.mcoexecutives.com NOTE: Barry Scheur is the featured interviewee on January 10th National Practitioner Data Bank-Healthcare Integrity and Protection Bank (NPDB-HIPB) to find out about backgrounds of physicians and other healthcare professionals at http://www.npdb-hipdb.com Looking for a medical conference? Try http://www.medicalconferences.com ---------------------------------------------------------------- End of PART ONE of TWO, The Managed Care Insider eNews, Volume Two, Number 1. Scheur Management Group (SMG) is one of the most experienced specialized healthcare operations management and business revitalization consulting firms in the country. Our expertise is in time-sensitive analyses, strategic business and market planning, operational re-engineering, and communications, as well as implementation of start-ups, expansions, and new products. The firm's clients cover the spectrum of insurers, managed care organizations, physician groups, integrated delivery systems, hospitals, employers, governmental entities, vendors, and other providers. Contributors to this edition are Barry Scheur and Dr. Paul Reich. Editing and Research by Judith Jaffe. Production Coordinator is The Gracefield Group at http://www.gracefield.com/gg/index.html TO SUBSCRIBE: visit http://www.scheur.com/smghome.nsf/webcontent/ezine.html or send e-mail to insider@scheur.com with the word SUBSCRIBE in the subject and name, email, company, title, and country in the message. TO UNSUBSCRIBE: send email message to insider@scheur.com with the word UNSUBSCRIBE in the subject. Please take a minute to visit our eNews page at http://www.scheur.com/smghome.nsf/webcontent/ezine.html for archives, subscriber information and to RATE our ezine. Get up-to-the-minute health care news on-line at www.scheur.com Go to January 2000 Part 2 |
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