That providers can communicate more openly and easily sharing information between them about patients. Thats especially important and helpful with Electronic Health platforms when the providers are on the same platform. This can reduce duplicate testing and even conflicting treatment. Payers and providers can share more Meaningful Health care data, Work Together on Health Care Analytics to determine what is the right improvement we can make to quality and cost . The providers within a clinically integrated network can be more familiar with each others, not just their medical practice protocols but their administrative practices. Allowing handoffs to be much smoother with less error. Then also these tighter relationships allow these providers to comment with the payers back to them where there are Service Needs and things that need to be improved. So ill go on to what we also want to talk about, though, and that is there needs to be adequate Consumer Protection and education. Especially
Coverage for example in one market where we are the narrower provider we found they had no access to pet scans. Another glitch we found as their exclusive Network Provider they had not contracted with any Lamp Services or radiation therapy. We can provide these services but frankly getting Outpatient Lab testing at your hospital may not be as convenient as some of the labs that are available with better parking and hours. Finally id like to reemphasize the reality of the marketplace is that price dominates. Premiums is what people are most likely to look at. Those with low income still leave outofpocket medical expenses that are unaffordable below this operation. As a result, even modest out pocket costs create affordability programs. This is from one of our markets. A married couple. Income 48,000 a year. They chose a bronze plan. Their premium is subsidized. They have a 3,600 deductible and a 12,000 potential outofpocket maximum. If one of this group needed a jant re placement or hth
That somebody can be get to in tough numbers and types in a reasonable amount of team states can look at the networks to make sure that that definition of reasonable is reasonable. When you look at the time it takes people to get to them, any waiting periods, any distance issues that you make sure that everybody can get to somebody in a sufficient way. If not, if there is an insufficient network the carrier makes sure the patient can go to another doctor or provider and that they would be not charged more for going to them. They require the carriers to file an access plan with the commissioner prior to offering the new managed care plan. What goes in that is a description of the network and also say how they are going to monitor the network on an ongoing basis. What their egregious procedures will be if somebody has a problem or question about the network. Notification. How do they notify if theres a change. Also, the continuity of care if somebody is dropped how are you going to make
Couple of years. You can get that as well which kind of looks at the issues that we are now going to be looking at as we look to revise our model. We have set up a subgroup which is currently doing regular phone calls. They are open phone calls, anybody, anybody in this room can sit in on them if you have nothing else better to do with your life. I always picture a 40yearold man in his mothers basement. I dont know why. You can provide comments anybody and everybody can provide comments, suggested changes, however you want to do it. Weve gone through a series of calls now where weve had all the stakeholders, the carriers, provide providers, consumers, of course, others that have come in and brought us their ideas. Were going to soon start the process of updating it. There are a couple of areas we are clear we need to update. One is essential Community Provider. Thats not something we were really looking at before. Are those now included in your networks . Theres also issues in the new
Will that investigation stretch into the upcoming president ial campaign . And unprecedented. Millions waking up to record low temperatures this morning on the heels of one powerful winter storm. Al says the first real signs of spring are finally on the horizon today, friday, march 6, 2015. Announcer from nbc news, this is today with matt lauer and Savannah Guthrie live from studio 1a in rockefeller plaza. And good morning everyone. Welcome to today on a friday morning. Matt has the morning off. Willies here. Maybe you have new material, something to say about the cold that has not already been said. Exhausted everything . Im out. You look at the thermometer on the plaza, 11 degrees, spring forward the clocks. Somebody forgot to tell the weather that spring is on the horizon. Record lows across the east. Through saturday and then, then. And then. Weesling out of it. He is a weatherman. Well check in with you. Harrison ford was injured after crashing his vintage plane after he reported