A new ACO option in Medica’s popular defined contribution plan promises quality outcomes, lower costs and a more coordinated, personalized experience
MINNEAPOLIS--(BUSINESS WIRE)-- Medica and Fairview Health Services announced today that the organizations are collaborating to offer commercially insured groups an accountable care organization (ACO) option in Medica’s market-leading defined contribution plan, My Plan by MedicaSM.
Under an ACO model, the provider and the health plan work together to improve the quality of care, manage the total cost of care and optimize the consumer experience.
Called Fairview Health Advantage with MedicaSM, this new ACO is the first of its kind in the region. It will offer My Plan by Medica members a reengineered approach to care and member service that extends across their interactions with Medica, a leading health plan, and Fairview, one of Minnesota’s largest health care provider systems.
It is the result of a collaboration between Medica and Fairview that began in 2009 when the insurer and health system agreed to share accountability for redesigning care and payment models achieving measurable improvements in the cost, quality and experience of care.
“Medica has been working with several care systems to improve the health of defined populations and, with our support, Fairview has achieved measurable improvements in cost, quality and patient satisfaction,” said Simeon Schindelman, Medica’s senior vice president of commercial markets. “By incorporating the Medica-Fairview ACO into our popular defined contribution product, we are giving more consumers the opportunity to directly experience the benefits of our collaboration.”
ACO Drives Better Quality, Service and Cost
My Plan by Medica members can already select from up to 20 benefit plan designs. Beginning April 1, they will also be able to choose whether to access their benefits using Medica Choice® Passport or the Fairview Health Advantage ACO, and will buy the combination which best fits their unique needs using pre-tax dollars contributed by their employers.
Consumers comparing the two options side-by-side will find their payroll deductions for the Fairview Health Advantage option to be as much as 50 percent lower.
Fairview Health Advantage features access to a localized network with nearly 2,000 physicians, more than 350 primary and specialty care clinics, and all the Fairview hospitals in the Twin Cities metro area, including University of Minnesota Medical Center, Fairview and University of Minnesota Amplatz Children’s Hospital.
Personalized Care, Tailored to Member Needs
My Plan by Medica members who choose Fairview Health Advantage will experience all aspects of Fairview’s innovative care model. For example:
- Rather than one physician, members will have a care team comprised of a primary care physician, nurses, pharmacists and other medical professionals, each with a key role to play in managing the member’s health.
- Medica and Fairview will work together to coordinate care management services for members with chronic conditions to ensure that services are not duplicated and that care is timely and appropriate to the patient’s needs.
- Upon joining the plan, members can take an online health assessment that gauges their readiness and capacity to improve their health status. The results of the assessment assist the care team in developing a plan that is reasonable for the member given his or her preparedness to work toward better health.
- Fairview Health Advantage with Medica provides coverage for email- and web-based “virtual” appointments with Fairview Health Network providers. Members will also have the option of home delivery for most medications prescribed during virtual appointments.
Integrated Service Creates New Consumer Experience
Members enrolled in Fairview Health Advantage will have access to another key feature: integrated on- and offline customer service for Fairview care and Medica coverage. The integrated service platform includes:
- Single phone number that members can use to contact either Medica or Fairview for assistance with topics such as claims and benefit questions, or talking with a triage nurse or scheduling an appointment. “This is the beginning of a new kind of consumer experience. Medica and Fairview are working together in ways that we believe people will appreciate and will directly contribute to an overall healthier, more productive and engaged population,” said Schindelman.
- Welcome phone call from a Care and Coverage Advisor, who will answer questions, assist the member in selecting a primary care physician, transition medical records and prescriptions from other providers, encourage completion of the online health assessment and schedule any appointments that might be needed.
- Dedicated web portal where members can look up benefits, view claims, search for network providers, access their personal health record, schedule appointments at Fairview Health Network clinics or arrange an online or virtual visit with their provider. Members will find all of their care and coverage information and resources through a single web address.
Medica (www.medica.com and newscenter.medica.com/) is a health services company headquartered in Minneapolis and active in the Upper Midwest. With approximately 1.5 million members, the non-profit company provides health care coverage in the employer, individual, Medicaid, Medicare and Medicare Part D markets in Minnesota and a growing number of counties in North Dakota, South Dakota and Wisconsin. Medica also offers national network coverage to employers who also have employees outside the Medica regional network.
Medica has the highest accreditation status, Excellent, from the National Committee for Quality Assurance (NCQA®) for its Minnesota Medicaid HMO plans and commercial health plans in Minnesota and North Dakota. Medica’s vision is to become the community’s health plan of choice, trusted for its integrity, respected for its service, and admired for its commitment to innovation and efficiency.
Based in Minneapolis, Fairview Health Services is a non-profit academic health network providing exceptional clinical care—from prevention of illness and injury to care for the most complex medical conditions. In partnership with the University of Minnesota, Fairview's 22,000 employees and 2,500 aligned physicians are committed to delivering greater value—exceptional patient care and experience at a lower total cost of care-—to the communities we serve. Fairview collaborates with physicians, payers and employers to transform health care through innovative care delivery and payment models.
Fairview’s continuum includes more than 40 primary care clinics, a wide range of specialty services, home care and senior services. Fairview also owns seven hospitals, including the University of Minnesota Medical Center, Fairview and University of Minnesota Amplatz Children’s Hospital. We provide care in urban, suburban and rural settings and strive to be the best health care delivery system for America, in partnership with the University of Minnesota.
Greg Bury, 952-992-8427
KEYWORDS: United States North America Minnesota
INDUSTRY KEYWORDS: Health Hospitals Professional Services Human Resources Insurance General Health