Presentation is loading. Please wait.

Presentation is loading. Please wait.

VIVA Health, Inc. Health Plan & Medical Home Benefit Information Session.

Similar presentations


Presentation on theme: "VIVA Health, Inc. Health Plan & Medical Home Benefit Information Session."— Presentation transcript:

1 VIVA Health, Inc. Health Plan & Medical Home Benefit Information Session

2 Page 2 Agenda  VIVA Health, Inc.  Who Are We?  Why Are We Here?  Plan Overview  Access to Care  The Patient-Centered Medical Home  The Kirklin Clinic Medical Home  Questions

3 Page 3 VIVA Health, Inc. – Who Are We?  A licensed health plan in Alabama founded in Birmingham in 1995.  Currently insures over 83,000 total members with approximately 50,500 commercial members and 32,500 Medicare members including: ◊ Drummond Company ◊ Birmingham Coca-Cola ◊ The Birmingham News ◊ UAB◊ Children’s Hospital ◊ Public Education Employees’ Health Insurance Plan

4 Page 4 VIVA Health, Inc. – Why Are We Here?  New medical option available through VIVA Health  Special Enrollment Period: March 22 nd - April 16 th  For Alabama Power employees who work or live in Jefferson, Shelby, or Walker County  Enroll by Phone or On-site  Phone Enrollment: 877-320-7504 or 205-558-7633  Coverage begins May 1, 2010  For more information visit our website www.vivahealth.com/apco  Opportunity to decrease out of pocket costs  Access to an enhanced benefit design and care delivery model

5 Page 5 Plan Overview $0 Copays for Primary Care Physician Visits – Compared to $25 on the Standard Plan (includes Internal Medicine, Family Medicine & Pediatrics) Medical Home Benefit $25 Copays for Specialty Physicians$0 Copays for Diabetic Supplies (30 day supply) $0 Copays for Outpatient Diagnostic Services (includes CT Scans, MRI, PET/SPECT, & ERCP) Prescription Benefits through CVS Caremark No Deductible

6 Page 6 Plan Overview – Access to Care  Extensive Provider Network in Alabama  Over 5,200 Providers  69 Hospitals  Over 95% of physicians in Jefferson, Shelby, and Walker Counties in the Network  All Hospitals in Jefferson, Shelby, and Walker Counties in the Network  98.81% of all providers used by Alabama Power Employees are in network.  Selection of a primary care physician is not required  Specialist referrals are not required

7 Page 7 Plan Overview – Two Options 1. Choose Viva Health Only  Go to any network PCP and enjoy NO COPAYS 2. Choose Viva Health and elect to become a member of The Kirklin Clinic Patient-Centered Medical Home  no additional cost to you  NO COPAYS for visits to your PCP and the Medical Home.  Note: with either option, visit any specialist with no referral required.  With either option take advantage of Viva’s exceptional customer service with dedicated customer service representatives with no automated prompts.  Viva Customer Service: 877-320-7504 or 205-558-7633

8 Page 8 The Patient-Centered Medical Home  What is a Patient-Centered Medical Home?  A vision of health care as it should be  A framework for organizing systems of care at both the practice and society level  A model to test, improve and validate  Video-Medical Home Introduction Video-Medical Home Introduction  © 2009 EMMI Solutions, LLC

9 Page 9 The Patient-Centered Medical Home  Superb access to care  Same or next day visits  Electronic visits  Improved care for chronic conditions  e.g. Diabetes, Asthma, Hypertension, and Heart Disease  Better detection of breast cancer, and reduced incidence and mortality caused by colon and cervical cancer  Care management  Quality reporting  Routine patient feedback to practice

10 Page 10 The Patient-Centered Medical Home  Clinical Information Systems that support high quality care  Electronic Health Record  Patient Portal  Electronic Prescribing  Disease Registry

11 Page 11 The Patient-Centered Medical Home – How Does it Work?

12 Page 12 The Patient-Centered Medical Home – How Does it Work?

13 Page 13 The Patient-Centered Medical Home – How Does it Work? Your personal physician  Nurse practitioner  Care manager (Nurse practitioner)  Nurses/Medical Assistants  Medical Secretary  Population Health Coordinator  Registered Dietician  Exercise Therapist  Clinical Pharmacist  Social Worker

14 Page 14 What Makes a Medical Home Different? Today’s Care My patients are those who make appointments to see me Care is determined by today’s problem and time available today Care varies by scheduled time and memory or skill of the doctor I know I deliver high quality care because I’m well trained Patients are responsible for coordinating their own care It’s up to the patient to tell us what happened to them Clinic operations center on meeting the doctor’s needs Medical Home Care Our patients are those who are registered in our medical home Care is determined by a proactive plan to meet health needs, with or without visits Care is standardized according to evidence-based guidelines We measure our quality and make rapid changes to improve it A prepared team of professionals coordinates all patients’ care We track tests and consultations, and follow-up after ED and hospital An interdisciplinary team works at the top of our licenses to serve patients

15 Page 15 The Kirklin Clinic’s Patient-Centered Medical Home MD Participants  Stuart Cohen, MD  Patricia Garver, MD  Jim Williams, MD  Michael Geer, MD  Analia Castiglioni, MD  Jennifer Vigil, MD (Coming in July) Financial support  VIVA Health Grant  UAB Health System The Kirklin Clinic

16 Page 16 The Kirklin Clinic’s Patient-Centered Medical Home

17 Page 17 Questions? www.vivahealth.com/apco VIVA Health, Inc. 1222 14 th Ave South 205-558-7633 877-320-7504


Download ppt "VIVA Health, Inc. Health Plan & Medical Home Benefit Information Session."

Similar presentations


Ads by Google