Physician Direct Starts 'Evidence-Based' Network

By Centrella, Heidi R. | THE JOURNAL RECORD, August 5, 2004 | Go to article overview

Physician Direct Starts 'Evidence-Based' Network


Centrella, Heidi R., THE JOURNAL RECORD


In an effort to address out-of-control health care costs and improve quality of care, Oklahoma City-based Physician Direct has launched an evidence-based health care network, which provides financial incentives for both doctors and patients.

This is the first of its kind in Oklahoma, noted Jeff Greene, CompOne Services chief executive officer and president. Physician Direct is a subsidiary of CompOne, an Oklahoma City-based physician billing and practice management company founded in 1997.

Physician Direct ePPO, with 4,600 participating physicians and 120 hospitals, utilizes evidence-based medical guidelines developed by leading universities nationwide. The guidelines are voluntarily accessed via the Internet by physicians and patients, each receiving financial incentives for participation. With its pay-for- performance incentive, doctors will be reimbursed 150 to 190 percent of what Medicare pays, and patients will receive a refund on co- pays and deductibles.

More than 100 guidelines have been developed, including everything from treating common ailments, such as asthma, to life- threatening diseases, such as cancer.

Evidence-based medicine, designed to provide the best possible clinical outcome, is believed by many to be a key ingredient in staving off skyrocketing health care premiums while improving the standard of care patients receive.

The Rand Corp. recently conducted a study determining that doctors run their best practices only 50 percent of the time.

They are doing things that are 'other than,' and often it's things that they learned years ago in med school and haven't changed, or things that they feel are more effective just because they have that feeling, and it's not based on the science of medicine, said Jeff Greene, CompOne chief executive officer and president.

And the science of medicine is how these guidelines are developed.

The city of Duncan was the first to get on board with the ePPO program in hopes of controlling its health care costs, which already was $380,000 over budget this year.

Last year, the city's claims expenses were close to $2 million. The city is a self-insured entity. Overall, the city expects a savings of $250,000 to $300,000 a year with the evidence-based ePPO delivery model.

The city of Duncan has 200 active employees, but the total covered by the city is about 500, with dependents and retirees.

Everyone always talks about the sorry state of health care in Oklahoma in relation to the cost of services and affordability, said City Manager Clyde Shaw. …

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