By: Nic Hayes
There has been a recent trend of health plans experimenting with integrating or acquiring their own primary care practices in an attempt to utilize a more provider-friendly approach to building a comprehensive healthcare solution. Due to the way these experiments played out in the marketplace, other health plans saw the potential benefit this model could bring but chose to do it differently by looking for a primary care solution as opposed to acquiring individual practices. As health plans begin to search for solutions, Proactive MD typically becomes their preferred choice as they explore what an advanced primary care solution could look like within a health plan/insurance product or environment.
“Based on the service that we’ve provided in our core business and the success that we've generated for clients, we’re uniquely positioned and have benefited from establishing a position of early consideration for [health plans seeking an advanced primary care solution].”
President, Proactive MD
In this relatively new segment, Proactive MD has been able to position itself as a resource for health plans who want to integrate an advanced primary care solution into their environment. From fully insured to self-insured to Medicare Advantage to marketplace health plans, Proactive MD supports the unique needs of each plan, its members, and its patient population through care, data, and cost.
Care Beyond Walls
In looking for a primary care solution, health plans are primarily concerned with the level of care that any solution they partner with will bring to their members.
Through partnering with Proactive MD, health plans bring their members access to Proactive MD’s Care Beyond Walls® model in which patient advocates walk alongside patients through their entire healthcare journey. Patients are guided to high-quality, cost-efficient specialists and facilities that deliver great outcomes (as well as optimizing the employer’s healthcare dollar).
When it comes to care, Proactive MD has achieved a 93 net promoter score which is multiple times better than their competitors in the space—highlighting the excellent level of care they provide.
Data-Driven Decisions
Proactive MD’s care offering is heightened through their use of data.
With data, Proactive MD is able to risk stratify member populations to proactively identify patients who would benefit from the preventative care and early interventions their model can establish. Additionally, through their integrated primary care model, they can act as a center of referral management and care coordination for their patients, allowing them to reach the optimal outcome.
In addition to risk stratifying patient populations, Proactive MD uses data to help clients realize a faster return on investment on their health plan dollars by offering a comprehensive care management program and platform that establishes predictable costs for that organization.
Containing Costs Without Cutting Quality
While other models on the market are fee-for-service driven, incentivizing them to focus on the volume of service rather than the quality or outcomes of that service, the Proactive MD model focuses on preventative care, early intervention, site-appropriate care, and coordinated management. With this focus, Matt Farnum, Senior Vice President and Head of Strategic Markets, explained, “We [Proactive MD] enter into value-based contracts with health plan partners to provide care for targeted, specific patient populations. Those contracts themselves are very detailed. They define the scope, the performance benchmarks, and the quality measures that have been proven in our industry to be correlated with high-quality, long-term outcomes for patients.” Proactive MD’s approach to partners ensures that efficient, high-quality care will be delivered through these contracts.
In the new and growing space of health plan-sponsored advanced primary care solutions, Proactive MD has already positioned itself to stand out with its patient-centric care model.
We are proud to feature Proactive MD on the Granite List.