wellmed network at a glance the a wellmed affiliated ... cardiology, family practice, hospital...
TRANSCRIPT
WELLMEDNE T WORK
the
A WellMed affiliated physician network.
NETWORKS OF FLORIDA, INC.
to a NEW Level of Health Care in the WellMed Network
an INTRODUCTION
To change the face of health care delivery for senior patients by providing
quality, proactive patient healthcare with a focus on prevention.
OUR VISION
INTEGRITY - Honor commitments made to patients and providers;
never compromise ethics
COMPASSION - “Patients come first”; provide a holistic approach
to care
RELATIONSHIPS - Collaborate with all health care providers to
improve the lives of patients and caregivers
INNOVATION - Improve efforts related to patient experience
PERFORMANCE - Demonstrate value to patient in how we manage their
health; require shared accountability across health care providers
OUR VALUES
Our name, WellMed, is a daily reminder of our objectives as a company.
Our mission is to help the sick become well and to help patients
understand and control their health in a lifelong effort at wellness.
OUR MISSION
WELLMED AT A GLANCE
Chairman and CEO
George M. Rapier III, MD
WellMed Footprint (Texas and Florida)
WellMed primary care physician and specialist locations – 98+
Contracted primary care physician locations – 1,248+
Contracted specialist locations – 2,760+
Total number of providers in the WellMed Network - 9,100+
Provider Certifications/Specialties
Dermatology, Geriatrics, Cardiovascular Disease and Interventional
Cardiology, Family Practice, Hospital Medicine, Internal Medicine,
Neurology, Osteopathic Medicine, Palliative Care, Pain Management,
Podiatry and Podiatric Surgery, Rheumatology, Wound Care, and more
Patients
280,000+
George Rapier III, MD Chairman and CEO
www.wellmedhealthcare.com
George M. Rapier III, MD founded WellMed in 1990 as a single clinic in the Medical Center area of San Antonio, Texas. He focused on preventive care and strong patient relationships instead of responding to the patient’s symptoms after they became ill.
Through our WellMed Care Model, our doctors provide more personalized attention, so our patients get more personalized care to live healthier lives.
THE WELLMED DIFFERENCE• We focus on the health and well-being of people with Medicare providing proactive,
preventive coordinated health care
• Physicians practicing in our Care Model are able to spend more time with patients to answer questions and explain test results
• We help provide affordable care to patients
• We help connect those who qualify with social and financial assistance programs
• We offer health care guidance 24/7
• Extended hours and walk-in times are available for patients in some areas
The WellMed Care Model was developed by physicians as a way to better treat our patients. We provide proactive medical care by monitoring them while they are healthy so we can better identify their symptoms if they do become ill. Patients are the foundation for everything we do at WellMed.
WELLMED CARE MODEL
© 2016 WellMed Medical Management. All rights reserved. 5/2016 CORPREC_ALL_CO110415
WELLMEDCARE MODEL
• Healthcare for all• After-hours access to medical providers• Accessible patient & lab info
ACCESS TO CARE & INFO
• Comprehensive care for both acute & chronic conditions• Prevention screening & services• Ancillary diagnostic services
PRACTICE-BASED SERVICES
• Collaborative relationships–ER, hospital care & specialist care• Care transition, palliative care & on-site social worker• Patient engagement and education
CARE COORDINATION
• Disciplined financial management• Cost-benefit decision-making• Facilities management
PRACTICE MANAGEMENT
• Electronic medical record• Electronic orders & reporting• Evidence-based decisions
HEALTH INFO TECHNOLOGY
CARE MANAGEMENT
• Physicians and nurses working with healthcare analysts to drive outcomes• Evidence-based best practices• Medication reviews
QUALITY & DataRAPS
• Provider leadership• Effective communication• Patient participation• Health Coaches
PRACTICE-BASEDCARE TEAMS
• Comprehensive patient-focused processes supporting providers in the treatment of chronic and complex patients in the effort to deliver successful outcome-based care• Wellness promotion• Disease prevention
PATIENTS
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M E D I C A L G R O U P
NETWORKS OF FLORIDA, INC.
M A N A G E M E N TM E D I C A L
N E T W O R K S , I N C .
“Given the invaluable resources WellMed provides to its network physicians, it has helped grow my panel size, patient volume and re-imbursements. I can take better care of my patients with better outcomes. WellMed’s staff is very professional, enthusiastic and eagerly involved with its physicians and patient care, which is very helpful. WellMed also helps to educate physicians on the Medicare health system unlike any other plan I have seen so far. It is a win - win situation for both patients and doctors.” — Dr. Anshul Agarwal
Founder and Medical Director Redbird Wellness Clinic in Dallas, TX
For more information visit WellMedHealthcare.com/affliated-physician-network,
call 855-835-1431 or contact the person who gave you this brochure
WellMed is a physician-led healthcare delivery system serving 280,000+ patients in
Texas and Florida through primary care clinics, multi-specialty clinics, and contracted
medical management services. Most patients are Medicare-eligible seniors.
Headquartered in San Antonio, Texas, WellMed is an industry leader in medical risk
management, highly effective disease management and chronic care programs,
healthcare delivery services, and more.* With a growing roster of primary care
providers and specialists in cardiology, podiatry, dermatology, rheumatology, neurology,
palliative care, wound care and hospital medicine, WellMed specializes in the complete
coordination of care for patients. WellMed’s contract entity supports more than 9,100
contracted providers and their patients in Texas and Florida under its partnership
with select insurance companies.
Our name, WellMed, commands respect and recognition for the work we accomplish
by keeping patients healthy and informed with up-to-date medical information and
resources. In 2011, a federally funded, independent, peer-reviewed case study by the
Robert Graham Center examined health outcomes for tens of thousands of WellMed
seniors in the San Antonio area. The study found WellMed seniors, on average, are
older and live longer than the 65+ population in Texas†.
In 2011, WellMed partnered with OptumCare™, one of the nation’s largest health
and wellness companies to further expand WellMed’s healthcare delivery system in
existing and new markets. To that end, WellMed has acquired more than 50 practices
representing 45 clinics in Texas and Florida since 2012.
The WellMed Vision is to change the face of healthcare delivery for seniors by providing
quality, proactive patient care with a focus on prevention. Through the WellMed Care
Model, we specialize in helping our patients stay healthy by providing the care they
need from doctors who care about them. We accept traditional Medicare and
contract with select Medicare Advantage health plans to help provide affordable
healthcare options.
WellMed Medical Management Inc. (WMMI), part of OptumCare™ – WMMI
is a “capitated, full-risk” Managed Service Organization (MSO) with an HMO structure.
We assume full-risk for our patients’ health through percentage of premium arrangements
with multiple payer partners. This means we manage the premium that insurance
companies receive from CMS for the provision of health care.
WellMed Networks Inc./WellMed Networks Inc. of Florida (WNI/WNIF) (501(a)) –
Physician led and managed, WNI/WNIF are WellMed companies which accept the
contractual healthcare insurance risk for contracted providers servicing the Medicare-
eligible population in Texas and Florida.
WellMed Medical Group, P.A. – A physician-led, physician-driven company specializing
in the complete healthcare coordination for patients in Texas.
WellMed Charitable Foundation – An independent, 501(c)3 non-profit organization
that supports seniors and caregivers in the communities we serve. Funding is raised by
community donors and WellMed employee contributions
Comfort Care Transportation, a WMMI entity – A transportation company catering to
eligible senior patients with a medical or financial need in several Texas and Florida areas.
Comfort Care provides this service to its members through WMMI contracts with select
Medicare Advantage health plans.
WELLMED BUSINESS MODELGREAT COMPANIES GROW GREAT PARTNERSHIPS
You probably became a doctor because you care deeply about people, their health and well-being. At WellMed, we create partnerships with physicians like you by offering the structure and the environment to grow your practice and enable you to focus on all the reasons that first motivated you to become a physician.
BECOME A CONTRACTED PHYSICIAN IN OUR WELLMED AFFLILIATED
NETWORK OF PHYSICIANS
In this partnership model, a physician with an existing practice enters into a contractual agreement with WellMed. The features and benefits are as follows:
• You maintain ownership of the practice
• You are not at risk for losses, but can share in surplus generated by successful care management
• WellMed supports the comprehensive care management of select Medicare Advantage health plan members
• Bonus compensation will be based on quality outcome metrics and a shared risk pool (varies by market)
WellMed is a capitated, full-risk Managed Service Organization (MSO) with an HMO structure. That means: • WellMed manages risk in Medicare Advantage plans through a percentage
of premium arrangements with multiple payer partners. Simply stated, we are responsible for managing the premium that insurance companies receive from CMS for the provision of healthcare.
• We help patients who are diagnosed with chronic diseases to prevent major complications and reduce hospital stays.
• WellMed shares the rewards with our team members for successfully managing patient care and maintaining healthier and happier patients.
CONTRACTED PROVIDER MODELWELLMED COMPANIESABOUT THE COMPANY
YOU’RE REWARDED FOR YOUR DEDICATION
You and your staff can earn extra compensation for achieving quantifiable results based on our patient quality metrics. Each metric is assigned a weight, target percentage, and a point value and is measured against a benchmark. Quality metrics are measured and reported throughout the year and re-evaluated annually.
GROW PROFESSIONALLY AND PERSONALLY
Senior healthcare is a major growth area for the future. According to statehealthfacts.org and the US Census Bureau, the Medicare-aged American population could grow 26% by 2020—up to 55 million people. WellMed is well positioned to continue to grow its facilities, staff, and services to fill this growing need, providing new solutions to address the health needs of seniors.
The WellMed Care Model enables you to provide efficient, comprehensive, and proven care techniques to treat the whole patient—physically, mentally, and socially.
WELLMED—PHYSICIAN OWNED, PATIENT CENTERED
WellMed is physician-centric and primary care-driven, similar to an Accountable Care Organization (ACO). As an early adopter of the ACO philosophy, we have continuously demonstrated how our healthcare delivery system can reduce costs and improve care while also enhancing your patients’ quality of life and even save lives.
* Recognized by Inc. Magazine as among the fastest-growing private enterprises 2009-2011; awarded the DMA: The Care Continuum Award for Disease Management program in 2008; recognized in Milliman Care Guidelines for protocols for knee replacement surgery rehab in 2009.
† Case Study of a Primary Care-Based Accountable Care System Approach to Medical Home Transformation. Journal of Ambulatory Care Management 34.1 (2011): 67-77. Print.
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