Care Management

Care Management

As physicians continue to experience tremendous change and fluctuation in our healthcare environment, there are also opportunities presented to collaborate, develop, and control the clinical processes needed to optimize patient care. At MED3OOO, we help physicians accomplish this by the process of Care Management.

Our physician leaders and clinical staffs have real-world experience in the most stringent managed care environments as well as competitive fee for service markets. Our collaborative local programs, based on established guidelines, provide a map of care for complex disease states, while protecting the decision-making process.

At MED3OOO, our focus is patient-centered and quality driven.

Our National Care Management committee has adopted MED3OOO minimal standard guidelines for the provision of preventive care services to our patients. They have also developed the MED3OOO disease management program for the prevention and treatment of osteoporosis.

The MED3OOO Care Management Committee meets each year to consider a number of new clinical initiatives and to review new evidence supporting changes in established guidelines. One of the recurring themes of the meeting is improvement in the quality of care. Presentations by physicians, payors and employers present to the group. During one of our meetings, the Director of Health Benefits from Verizon detailed an employer’s perspective of quality care, other sessions have addressed the quality in managed care and in fee for service settings, and most recently we have focused sessions on Population Health Management. MED3OOO patient recalls have been identified as an important and effective tool in ensuring that patients receive needed care on a timely basis. Dr. Gary Proffett (Medical Director, SeaView IPA) has presented to the the committee "Pay for Performance" initiatives and the use of hospitalists to improve outcomes. There have also been roundtable reviews of new hypertension guidelines issued earlier this year in the Joint National Committee publication (JNC 7).. A new classification was noted, called "pre-hypertension," wherein patients with a blood pressure between 120/80 and 140/90 should be considered for lifestyle changes or medication.

Highlights of clinical determinations made by the Committee included:

• Adding Metabolic Syndrome, hypertension, and hyperlipidemia as conditions indicative of the need for diabetes screening.
• Recommending Aspirin and aggressive dyslipidemia therapy in management of diabetic patients, but not recommending magnesium supplementation, apoB measurement, or coronary artery calcium screening for diabetics, based on insufficient evidence at this time.
• Changing current MED3OOO mammography recommendations to annual screening of women of average risk between the ages of 40 and 49 (previously, this was recommended biannually). There will continue to be no upper age limit; evidence supports continued benefit of annual screening at upper ages.
• Encouraging physicians to consider providing osteoporosis screening services to males age 70 and over, exploring pharmaceutical partnerships for educating and screening this population.
• Adding parathyroid hormone and risedronate to the osteoporosis treatment algorithm, while removing "consideration of HRT."

With the help of the Practice Improvement Initiatives and the MED3OOO IQ™, these have become an ongoing part of our doctors' practices. For more information regarding these guidelines and MED3OOO's disease management programs contact Geoff Coleman at GEOFF_COLEMAN@MED3000.com or at 1-888-811-2411.