HealthPlus can assist you in providing quality care, through effective practice management.
HealthPlus collaborates with the Michigan Quality Improvement Consortium (MQIC) and with input from its practitioners, to develop clinical practice guidelines based on nationally recognized, evidence-based guidelines. The guidelines are developed for high-priority clinical areas identified based upon plan demographics, prevalence of clinical conditions, cost of care, and service utilization.
HealthPlus’ goal is to improve patient care by developing, implementing and monitoring scientifically sound, evidence-based guidelines; however, none of the guidelines are intended to replace a physician’s clinical judgment, in treating an individual patient.
Each clinical practice guideline is reviewed and updated every two years, either by MQIC or by HealthPlus, with new guidelines introduced periodically to assist in managing the important aspects of clinical care. The guidelines are reviewed and approved by the HealthPlus Quality Improvement Committee and Board of Directors.
Clinical Practice Guidelines adopted and approved by HealthPlus are available on the HealthPlus website. Clinical indicators monitored for specific guidelines may also be included as an attachment to the guideline. Hard copies of the guidelines are available upon request. The HealthPlus ProviderPlus newsletter includes announcements of new and updated guidelines.
The HealthPlus Formulary aids physicians and pharmacists in providing cost-effective medication therapy while maintaining a high quality prescription drug benefit. This is achieved by selecting agents, including generically available medications, listed in the HealthPlus Formulary.
Tips for Efficient Practice Management
Following the suggestions below can help you improve the efficiency of your practice management and help enhance your delivery of patient care.
- Always take a positive approach with patients. Let them know that the PCP can improve the quality of care through a coordination of health care services.
- Utilize generic drugs whenever possible. The average cost difference between a generic drug and a brand name drug is at least $90, and often is a much greater difference in cost.
- Perform a health assessment at least every 1-5 years for early detection of illness and disease.
- Encourage your patients to complete their immunizations.
- Discuss how your patients can become more involved with their wellness and treatments through wellness programs.
- Be actively involved in the care of hospitalized patients. Inpatient services and costs can be managed more effectively if the PCP is involved in all aspects of patient care.
- Take the time to coordinate health care by communicating with other health care providers who treat your patients. Be explicit with instructions related to required services and location of service, including DME suppliers.
- Provide pertinent medical history to specialists. Obtain reports from specialists after their rendering of services to a patient.
- Be accessible to patients via telephone outside normal business hours. Frequent checking in with an answering service encourages proper coordination of health care. Provide clear instructions to patients in your answering machine message, and provide your answering service with instructions on receiving calls from your patients.
- Direct patients to urgent care centers rather than the emergency room, when medically appropriate. Be sure your answering machine/service has the appropriate information.
- Utilize Joint Venture Hospital Laboratories (JVHL) or Quest Diagnostics Laboratories.
- Select DME providers listed in the HealthPlus Provider Directory.
- Direct patients to HealthPlus approved diagnostic services facilities (e.g., CT scans, routine x-rays, etc.).
- Schedule physicians and nurses for telephone conversations with patients, to provide referrals or coordinate other care, to avoid repeat visits.