Preventive Health Measures Rise Sharply
A Model of Success from MMM Healthcare, Inc.
In the last decade, experts have pointed to preventive care as a key to solving the nation’s healthcare crisis. This is especially true in the last year as the nation searches for ways to curb rising healthcare costs and improve the health of the nation.
As healthcare leaders – from local doctors to national policy makers – recommend guidelines for early detection and better management of chronic illness, MMM Healthcare, Inc. (MMM) has taken action to provide plan beneficiaries with greater access to the kinds of screenings that save lives.
The quest for preventive measures at MMM started with a vision to provide healthcare services that don’t just treat beneficiaries but truly improve their quality of life before care is even needed. The comprehensive Care Management Program is member-centric and facilitates collaboration between members and their healthcare teams. In addition, the program promotes self-management, active decision making, healthcare education and participation in healthcare interventions and disease prevention.
As more and more seniors signed up for the plan, the company started to see results and is today celebrating a more healthy population*:
- 24 percent more women are being screened for breast cancer
- 77 percent more individuals are being screened for colorectal cancer
- 75 percent of beneficiaries are being screened for diabetes
- 90 percent of beneficiaries are being screened for cholesterol issues
- More than 40 percent of beneficiaries are controlling their high blood pressure
- 166 percent more beneficiaries are controlling their cholesterol levels
Each of these results is a medical achievement – and, more importantly, is part of MMM’s goal to increase the health and well-being of every life we serve.
*All numbers display increases from 2004 to 2009
IPA Rebounds from Lapsing Into Debt, Contemplating Dissolving
A Model of Success from NAMM IL
There’s no escaping financial challenges that cause a group of physicians to contemplate the end of their work together. Well, there’s seemingly no escape…
NAMM IL immediately responded to one struggling physician group with a step-by-step action plan that brought them back to financial stability. Reimbursement and expense audits, reinsurance recovery and financial planning became the keys to a solid recovery plan for this IPA. To implement it, NAMM IL’s Health Services team worked in conjunction with our business team to implement cost containment measures that adhered to the necessary, evidence-based care guidelines – allowing optimal revenue and cost containment.
NAMM IL further implemented improvement processes for ambulatory management, emergency room utilization and inpatient case management – which included implementation of a hospitalist program. Standard metrics and trending provided for a comprehensive program that continually improved and responded to provider issues.
In the end, the IPA was able to better maximize its revenue potential and – most importantly – survive.