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Pro Pharma Announces a Scientific Approach for ACO and HealthCare Exchange Program Oversight
Pro Pharma is announcing Financial and Clinical Outcomes Management and Quality Management Program™ Interventions to assist Physician Provider Groups and ACOs in demonstrating that they can effectively manage utilization and decrease cost.
Dr. Stern, President of Pro Pharma, notes that “there is at least one thing that ACO’s and Exchanges have in common; they are both group efforts. And, as groups, they require information to manage their processes and outcomes for success”
MD groups and ACOs need to demonstrate that they can manage utilization and decrease cost. They need data to identify utilization, cost, and quality gaps. Dr. Stern continues to explain that “actually, the identification and cure of quality gaps will have as a consequence decreased cost trends and control over utilization. Exchanges will need to demonstrate comparable or above average performance in cost, utilization and quality as well. The survival and long-term viability of Plans in each Exchange will be dependent on their ability to demonstrate excellent value for the money that beneficiaries spend.”
Process Management can make a group more productive. Dr. Stern states that “Outcomes Management attempts to improve the financial, utilization and clinical outcomes of the individuals touched by the ACO, and the businesses and individuals touched by the Exchanges is imperative.” Since the bottom-line is that both ACOs and Exchanges will be judged by their outcomes, it is good business practice to implement programs now.
The surgical use of data to identify specific actions that can be taken by individual physicians and groups ultimately leads to outstanding performance of target groups when compared to control groups. This experience has been duplicated time and again for provider groups who drove to improve their quality performance in order to improve their internal financial positions and their sales positions to Health Plans.
Carol Stern, CEO of Pro Pharma, states that “Pro Pharma provides Financial and Clinical Plan Comparisons (http://www.propharmaconsultants.com/
Please contact Pro Pharma if you are interested in exploring how the results of Pro Pharma's scientific approach to oversight and management can work for your organization utilizing our verifiable and validated programs.
About Pro Pharma Pharmaceutical Consultants, Inc.
PRO PHARMA is a multi-service, woman owned, privately held consulting firm offering a vast portfolio of services to public and private entities including self-insured employers, Taft Hartley Trusts and unions, public employers, for-profit hospitals and integrated health networks, health care insurance companies, worker's compensation insurers, small-to-medium sized HMO's, and physician groups.
As a primary service to plan sponsors for achieving below trend results, PRO PHARMA provides an integrated program of administrative process improvements, clinical quality oversight, and provider/member education.
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