My name is Jeff Galles.
I'm a physician, and I've been practicing with Utica Park Clinic for about 25 years.
I've been chief medical officer for about the last 13 years.
And my role is really to oversee quality and our performance improvement programs within
the group.
One of the valuable components of our relationship with Humana is really their ability to work
within our system to help us make that transition from a fee-for-service model into a value-based
model of care.
And part of that was providing data so that we can make that transition.
That included providing cost data, performance data in terms of our quality measures, and
really how to partner with them to make those improvements in each of those metrics.
My name is Meredreth Maynard.
I am the director of quality improvement here for the Oklahoma Physician Group, Utica Park
Clinic.
We have multiple responsibilities within our quality team, everything from risk management
to clinical education, a lot of quality assurance activities, but one of their major responsibilities
is around the Medicare Advantage population health management, and management around cost
and quality, and member engagement for those Medicare Advantage plans.
I think the evolution of our relationship with Humana has been really exciting.
It initially began with a lot of hand holding, we were kind of spoon-fed data based on what
we felt like we were able to accomplish, and over time we began more aggressively to reach
out and ask for more information.
Now, we're more engaged in pushing our staff out to the Humana database and pulling data
as we need it, and as we pull data, we support different programs that we've initiated.
Initially, just like all of our providers when we roll out reports or data, everyone
kind of looks at it with, you know, a level of skepticism, a level of, "How do I validate
that this is truly what is happening?
Is there going to be actionable data that we can do something with?"
And once we began to look at it from a high level and certain leadership that was exposed
to it, sort of seeing that, no, this really is true of our population.
This data does seem to be valid and applicable.
We began to look at the things that we were struggling with and diabetic eye exam was
a good example.
Humana was very good at partnering with us and helping us look at opportunities we might
have with bringing in retinal cameras into our practices.
And now we've really expanded that program that was started as a pilot into retinal cameras
in almost all of our primary care practices.
We can see, OK, what true gaps does this patient have?
We don't want to, you know, waste our resources reaching out to patients who have already
had their breast cancer screening for that year.
You know, a lot of that decreases their confidence in us if we're constantly asking for the
same information that they've already completed.
So, I think having those pictures at the point of care improves the confidence the patient
has in us as a provider group and as a health plan that they're working together and they
know me well.
One of the advantages I think of having relationships with payers is that we've seen more data
now on our patient population than we ever have in the past.
We see the data earlier in the year, and so with our Medicare Advantage patients we're
not waiting until May to see data and begin outreach.
We've been really able to track data over the last several years and see the improvement
that we've garnered as a result of that.
We've seen the reduction of hospitalizations and readmits, and ER visits.
And so, they've kind of put the other payers on the spot of, "What else can you bring
to the table?
Humana does this.
What can you do?"
And it has helped their quality of care throughout the whole population.
There's no debate that our patients see the benefit of value-based care.
I think that when we have resources to provide that help us do more aggressive outreach,
help us focus on our high-risk patient population, our patients really acknowledge the importance
of that.
Those patients who make comments like, "I can't believe that you called me after I
left the hospital" or that "You called to let me know that I was due for diabetes
care or blood pressure monitoring," are things that they've never experienced before
in their relationship with a provider group.
So, I think having that goal of providing high-quality care and having infrastructure
and funding to support that has really impacted our patients in a way that we didn't expect.
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