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The primary
goal of the Patient Physician Network is to proactively respond
to the changing healthcare environment of the Metroplex by introducing
the concept of healthcare reengineering. The PPN will assist physicians
to combine quality of care issues with cost, utilization, and outcome
data to ensure patient accessibility, efficiency, education, promotion
of wellness and prevention of disease.
The organization
recognizes its future is linked to the successful establishment
and ongoing operation of a clinically integrated physician delivery
system. The PPN's primary goal of reengineering the healthcare system
is realized through achievement and maintenance of clinical integration.
Clinical
Integration includes, but is not limited to:
- Employing
a medical director and support staff
- Installing
information systems for the purpose of gathering data, measuring
performance against cost and quality benchmarks, and monitoring
patient satisfaction
- Involving
physician contractors in the development of standards and protocols
and in monitoring the care rendered throughout the Company's network
- Implementing
quality assurance and utilization review policies and programs
- Undertaking
retrospective reviews of inpatient stays
- Conducting
regular evaluations of the Company's and its physician contractor's
performance with respect to quality assurance, utilization review,
or other performance goals
- Modifying
the Company's performance and assisting physician contractors
to modify their practices as necessary or appropriate to achieve
desired quality assurance, utilization, or other performance goals
- Developing
and implementing practice standards and protocols
- Reviewing
care in light of such standards and protocols
- Furnishing
payors with detailed reports on cost, utilization, and the achievement
of network goals
- Maintaining a
sanctioning body or mechanism to expel from the network a physician that consistently
fails to meet the network goals
The joining
of our physician's many years of clinical experience with detailed
analysis of claims data provides medical information that can significantly
improve the health of the community that we serve.
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