Wednesday, September 18, 2019

MCS Advantage physicians will receive greater compensation

By on August 29, 2019

Independent Practice Association reception (Courtesy)

Provider develops tools to incentivize medical talent, better patient care in Puerto Rico

SAN JUAN — Managed healthcare plan provider MCS is increasing the compensation it offers primary physicians participating in the MCS Advantage Inc. provider network and affiliated with the Independent Practice Associations (IPAs). 

The increase will take effect Oct. 1 and includes payment for quality and good performance to promote “the retention of medical talent and better health care.”

In addition, the insurer has developed new technological applications, educational initiatives and the Physician Business Partner Program to help make it easier for providers to maintain “the outstanding performance necessary to receive the compensation increase for service quality,” the company announced Thursday. 

“MCS has designed this compensation plan with the provider in mind, because we recognize the professionalism of doctors who strive daily to provide the best care for their patients. The expectation of this competitive compensation plan for IPA primary physicians in our network is to achieve a positive and immediate effect in the retention of our medical talent in Puerto Rico, as well as in caring for patients’ health. We especially bet on our Physician Business Partner Program to work as a team with our providers in new initiatives aimed at promoting our insureds’ wellbeing. It’s a winning platform for all the parties involved,” said Jim O’Drobinak, chief executive officer at MCS.

O’Drobinak added that, for healthcare to be of the highest quality, it must be based on knowledge and data analysis related to the needs of the insured. Therefore, under the MCS Conexión de Salud technology pillar, MCS has developed the My Stars and Carebook applications. In addition, under the education pillar, the ongoing exchange of knowledge will be promoted through symposiums and informative capsules. 

The My Stars and Carebook applications allow primary physicians in the MCS Advantage network and affiliated with IPAs to more closely monitor their patients, make adjustments to their treatments, and establish effective intervention plans that adequately address their patients’ conditions. 

“Not only did we improve our compensation plan, but we took it a step further by offering our primary physicians the technological tools to help them maintain those quality healthcare parameters,” O’Drobinak said.

Roberto Torres, the executive vice president of operations who oversees the Providers function at MCS, said increases in value-based compensation are awarded as providers comply with certain metrics, including quality and access to service, patient satisfaction and the integration of technological resources in medical care. 

“Providers will be rewarded when all these elements converge in an improvement in the results shown by the patient,” he added. 

Dr. Inés Hernández, MCS’s chief medical officer, explained that with CareBook, doctors are able to access a patient’s health service utilization history and view all their health conditions, medications, laboratory and vaccine history, claims reports, visits to other doctors, and whether the person has been hospitalized or in an emergency room during the last 12 months. 

“Having all the utilization history on their computer screens, doctors can make a positive impact on their patients’ health by recommending the appropriate clinical care treatment plan,” she said. 

Hernández also pointed out that this virtual clinical information bank will, for example, help doctors determine whether a patient is eligible to participate in any of the Care Management programs MCS provides to its members to help keep their conditions under control. 

“In fact, of our entire population, MCS Classicare members who participate in our innovative Care Management programs have the lowest rate of hospital readmissions, visits to emergency rooms and the development of complications,” the doctor explained, emphasizing the importance of working as a team with medical service providers for a positive impact on patient health. 

MCS also announced the rollout of the My Stars application, which will give providers “complete, accurate and structured information to help them establish effective action plans for identifying and closing patient Gaps in Care,” the provider explained.

“With the new My Stars technology, all doctors will have better visibility into their progress in all Stars metrics,” commented Ixel Rivera, who oversees the Stars function at MCS as executive vice president of Clinical Operation. 

“We strongly feel that physician performance in the Stars area will improve with these tools,” Rivera said while highlighting the symposiums and informative capsules that stem from the MCS Conexión de Salud program to foster the exchange of ideas among providers. 

“Through collaboration, providers are also helping each other achieve better quality standards in their medical practices,” Rivera said proudly of the program structure to incentivize physicians and deliver better patient care.