US Family Health Plan: Providing High Quality, Cost Effective Healthcare to Military Beneficiaries By: Marshall Bolyard, Executive Director, US Family Health Plan, CHRISTUS Health
US Family Health Plan Background & Historical Perspective
Origins 1981: PL transferred ten US Public Health Service (PHS) hospitals and clinics to private, not-for-profit healthcare entities PL designated these former PHS facilities as Uniformed Services Treatment Facilities (USTFs)
Origins 1989: Congress requests the development of a managed care delivery system 1993: US Family Health Plan is born 1997: USTFs become designated providers and made a permanent part of the MHS
Alliance of Designated Providers
Model, Measures & Reasons for Success
Model Managed care / coordinated care Capitation Fully at risk Commercial & Medicare population Access to government prices for pharmacy
Measure The best measure of our success is the consistently high levels of patient satisfaction
Member Satisfaction Comparison to national averages for member satisfaction with HMOs (all percentages = proportion highly satisfied, rating plan 8 through 10 on a scale from 0 to 10, where 10 is the best possible plan)
Reasons for Success Prime contributors to high rate of acceptance: Population based care Provider based care Full risk for care Care Management & Disease Management Primary Care Manager Customer Focus
Why this Model is a Good Model for the American Healthcare System
Summary Intimacy between patient and provider Focus on population health, not fragmented care Patient centric Members for life