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August 10, 2009 | American Medical News

“Gently” managed care (America’s Health Insurance Plans annual meeting)

“At the annual meeting of America’s Health Insurance Plans, held in San Diego in June…were…firms vying to sell health plans the perfect care-management tool.

“All promised a means to gently, effectively use physicians to change patient behavior in a way that doesn’t alienate either the patient or physician, and results in savings for the insurer.

“Some vendors, such as Emeryville, Calif.-based MedeAnalytics, offer software packages for hospitals and health plans…

“Proponents say that under a health plan's care-management system integrated into its existing portal, doctors would be prompted at the time of care to follow pay-for-performance guidelines. Tracking success would be simpler, and the clinical rationale for the pay-for-performance incentives would be delivered to the doctor at the time of care. ‘As annoying as pay-for-performance can be, physicians know it's coming, so the more opportunity they can have to get access to data [that supports payments], the better,’ said Terry Fouts, MD, chief medical officer for MedeAnalytics.”

 

Source: “’Gently managed’ care (America’s Health Insurance Plans annual meeting),” AMNews, Aug. 10, 2009, http://www.ama-assn.org/amednews/2009/08/10/bisa0810.htm.

“As annoying as pay-for-performance can be, physicians know it's coming, so the more opportunity they can have to get access to data [that supports payments], the better.”

Terry Fouts, MD

Chief Medical Officer
MedeAnalytics

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