ST. LOUIS, Aug. 17 /PRNewswire/ -- Blue Cross Blue Shield of Missouri (BCBSMo) is hosting its inaugural Physician Group Partners Program(R) (PGPP(R)) Awards Forum on Tuesday, August 23, at the Hilton Frontenac, 1335 South Lindbergh Boulevard, St. Louis. The awards are being given to physicians who have adopted innovative ways to achieve patient satisfaction and quality goals. A continental breakfast will be served at the event scheduled from 8 a.m. to 12 p.m.
PGPP group members, other BCBSMo network physicians, brokers and employer group members are expected to be in attendance to hear presentations from the honorees. Dr. Charles Bentlage and Dr. Richard Schooler of Freeman Health Systems will be presenting “Making Performance Happen with Continuous Feedback and External Benchmarks.” Dr. Thomas Hale of Mercy Medical Group will present “Pay for Performance and the Electronic Medical Record: A case for provider payer performance.”
The keynote speaker for the event will be Susan K. Moore, RN, MHSA, president of Managed Healthcare Resources, Inc., of Ortonville, MI. She assists managed care organizations and Medicaid health plans in meeting state requirements, Medicare Quality Improvement System for Managed Care standards, and NCQA managed care organization and new health plan guideline standards. There will also be a presentation by Michael Kloos, PharmD, Pfizer, titled “Adherence to Anti-Depressant Medication and Quality Improvement.” Pfizer is a co-sponsor of the PGPP Awards forum.
Started in 1996, PGPP was designed to give more control for patient care delivery to primary care physicians in group practices, according to John Seidenfeld, M.D., vice president and medical director of Blue Cross Blue Shield of Missouri. “The program supports physicians with tools, information and resources that they can use to meet patient needs more effectively,” he said.
This voluntary program provides opportunities for physician groups to focus on improving patient satisfaction and clinical outcomes while controlling medical costs. Physicians can earn additional compensation if patient satisfaction and quality goals are reached. It works opposite of those programs that reward physicians for denying care to their patients.
At the heart of the HMO program are measurable HEDIS-based quality standards that Blue Cross and physicians develop. HEDIS -- Healthplan Employer Data and Information Set -- is considered the definitive set of managed care performance measures developed by major employer groups and health plans in order to provide an industry-wide set of standards to compare HMO performance. The company provides groups with quarterly reports on the status of the group’s physicians and compares them with the entire network. Registered nurses with clinical and managed care experience work as physician practice consultants to analyze and present the data the plan has compiled, identifying any problem areas to the physician groups. Physician practice consultants facilitate data analysis and promote an interactive relationship between physicians and the company.
The program results have been encouraging -- physician groups that participate in this innovative program are consistently scoring 91 percent or higher on patient satisfaction, as measured by surveys of patients’ experiences with their doctors. They also score significantly higher on selected HEDIS-based quality indicators. For example, a comparison of 2003 and 2004 quality results for PPO participating groups shows a 21 percent improvement, compared to a 14 percent improvement for network physicians who do not participate in PGPP.
Blue Cross Blue Shield of Missouri is the oldest and largest health benefits company in Missouri. Blue Cross Blue Shield of Missouri is an operating subsidiary of WellPoint, Inc., the nation’s largest publicly traded commercial health benefits company serving the health care needs of approximately 28.8 million medical members nationally. Blue Cross Blue Shield of Missouri is an independent licensee of the Blue Cross and Blue Shield Association and can be found on the web at http://www.bcbsmo.com .
Blue Cross Blue Shield of Missouri is the name RightCHOICE Managed Care Inc. (RIT) uses to do business in most of Missouri. RIT and certain affiliates administer non-HMO benefits underwritten by Healthy Alliance Life Insurance Company (HALIC) and HMO benefits underwritten by HMO Missouri, Inc. HMO Missouri, Inc. does business as BlueCHOICE. RightCHOICE and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. RightCHOICE, HMO Missouri, Inc. and HALIC are independent licensees of the Blue Cross and Blue Shield Association.
Blue Cross Blue Shield of Missouri
CONTACT: Deb Wiethop of Blue Cross Blue Shield of Missouri,+1-314-923-4767, wiethopd@bcbsmo.com
