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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. We believe that 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 Ins/der readers. |
