Friday, December 14, 2018

MSO of Puerto Rico, MMM Healthcare increase physician compensation

By on September 21, 2018

SAN JUAN – Healthcare management provider MSO of Puerto Rico, and its insurance subsidiary, MMM Healthcare, announced Friday that physicians in its network would see an increase to their base compensation as of Oct. 1.

The raise, the company said, will reflect “payment by value instead of by volume of patients…thereby acknowledging the dedication and professionalism of physicians based on the care of their patients.”

MSO provides contracting services, claims processing, coordinated care, training and continuous education, facilitation of administrative processes, and information technology and finance support to medical groups throughout the island. Its MMM subsidiary is an HMO plan that offers a Medicare Advantage plan.

“After extensive discussions and dialogue with different medical organizations, together we have decided to set aside the differences and work on agreements that bind us together, collaboratively and with respect. We have worked on initiatives that promote the retention of medical talent such as the program dedicated to hiring recently graduated physicians, and the issue of payment of premiums,” explained MSO’s president, Dr. Raúl Montalvo. “The increase in compensation provides for adjustments in the major codes and greater volume for the Group of specialists, in tune with the new models and federal regulations, at the same time that reaffirms the importance of the role that doctors have in prevention and integrated coordinated care of patients affiliated to MMM.”

Meanwhile, the president of MMM, attorney Orlando González, said the insurance company has works closely with its network of specialists and “continuously invite doctors to be part of our forums to discuss various issues, such as the so-called brain drain of medical talent, insurance premiums, new products and innovative solutions focused on promoting coordinated care models” to better serve patients.

These rate increases are on a par with the new Medicare Access and CHIP Reauthorization Act (MACRA) regulations, according to the news release.

“We established a new metric system based on performance that will allow us to increase the compensation specialists receive for serving greater-risk complications and mortality conditions such as cardiac, respiratory, diabetes and severe depression,” Montalvo explained, adding that the compensation increases based on performance will be effective Jan. 1 and “will be awarded according to the individual fulfillment of specific metrics” but do “not imply changes in case the physician does not comply with these new compensation metrics.”

A “[m]etrics-based model promotes and facilitates access to an even better individual care, since it measures quality of service, access and patient satisfaction, use of resources or the adoption of technology. These compensation models are added to other already existing models based on best practices, high volume of patients and level of participation within an IPA group,” Montalvo further said. “A doctor, who has an outstanding performance, can obtain compensation for performance that may be even greater than the already established, and good pay is an incentive for retention.”

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