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MRHC Newsletter
October - December 2002 Issue
Activities of your Cooperative:
Group Health Insurance: Many of our members have expressed an interest in
the prospect of saving money by purchasing group health insurance through MRHC. One of the benefits of the co-op is that the co-op can act as an umbrella under which all interested members may be recognized as one
larger entity by health plans so we can all save money. It may be more likely that we will see the biggest benefit by creating a self-insured health insurance product that we can directly control and save health
plan overhead. We are pursuing both options. Please let us know if you are interested in participating let us know. As this develops we will need additional information from you.
Group Malpractice Insurance: Several of our members have expressed an
interest in the prospect of saving money by purchasing group malpractice insurance through MRHC. This is somewhat difficult as it is something of a seller’s market, meaning vendors will be less inclined to discount
the price of their product. This said, I strongly believe that discounts are possible if entities are willing to consider changing carriers and doing this as a block through the co-op. Remember that we don’t need
every entity but the larger the block the more clout we have.
Assisting members with HIPAA compliance extension: We strongly recommend
that all of our members complete the HIPAA compliance extension before October 15, 2002. Most have already done so but I believe some have not. Members may believe that it doesn’t apply to them and technically it
doesn’t if they do not submit any claims electronically. The problem is that Medicare is planning to mandate electronic submission at some point in the near future (you won’t get paid if you don’t submit
electronically) and at that point you will need to be HIPAA Compliant. Also, while it hasn’t happened yet, I anticipate that all health plans will mandate HIPAA compliance and as your contract holder we will need to
enforce this as well. Please call us soon if you need help filing your extension.
Assistance with implementation of RBRVS: Many of our members have
implemented the RBRVS system that Medicare and most health plans use. Utilizing RBRVS helps standardize your fee schedule and minimize contractual adjustments and maximize your net collections. We will assist you
with an RBRVS review or implementation if you are interested.
Hospital and Clinic compliance audits: We have done a hospital and a clinic
compliance audit. We review the entity’s compliance plan, interview applicable personnel, perform a walk through of the business office, compile a report, and present results to customer. This gives entities an
initial review from an outside perspective. Comparable service from consultant’s is $8,000 - $10,000, our price $0.
CME opportunities Spring and Fall: We had a Continuing Medical Education
(CME) event in Willmar September 24th that was received well by 50 attendees. Glaxo Smith Kline sponsored the event that included a great meal, Cardiology education, coding training, and CMEs for physicians, allied
health, nurses, and medical assistants at no cost to the attendees. We plan to continue providing similar CME events with various topics each Spring and Fall provided we can arrange sponsorship.
Regional Electronic Medical Records (EMR) system: We will be working on
developing a regional EMR system that would connect interested members and provide economies of scale, group purchase savings, and would hopefully be partially funded by grants. Interested members should contact us.
Health plan contracting: Current health plans we currently hold for our
members include: Araz, Blue Plus (for Primary Care clinics only), Corvel, HealthPartners, Medica, One Health Plan, PreferredOne, PrimeWest, and UCare. We are currently negotiating with Multiplan, and Avera as
possible additions. We have taken the position that we want win-win contracts that allow acceptable access for our patients but also that are acceptable to our members in terms of reimbursement and contract
language.
One achievement we have had this year is the inclusion of several of our member clinics in Blue Plus’ Advantage State Health Plan network. It
should also be noted that the tiering our member clinics have is at the best level possible, tier 1, which helps them retain all of these patients.
Membership: We are now actively recruiting new members to grow in size to increase our bargaining power and to reduce per member annual dues. Let us know of potential clinic and hospital members. These new members can be from Minnesota, and North and South Dakota.
Please welcome our newest member the Williams IntegraCare Clinic in Sartell, MN (near St. Cloud).
Dr. Lyle Munneke, founding chairperson of the Minnesota Rural Health Cooperative, to Retire in December 2002
Dr. Munneke’s thoughts regarding the Minnesota Rural Health Cooperative: It
all started several years ago when I got a report when a Blue Cross representative presented our contract for the coming year.
I asked some questions and was told, “I don’t need to answer your questions. Take it or leave it. We have plenty of providers without you.” They had special contracts with larger groups and didn’t care about smaller groups. I saw a decline in smaller private clinics and hospitals and patients loosing their clinics, care with nowhere to go. We need to find ways for the members to work more closely together not only in negotiating contracts and periodicals but to provide more quality and a uniform health care delivery system. We need to find ways to increase the value of, and to retain the present membership of, and expand the network for more providers while at the same time provide leadership and be a model for the delivery of Rural Health Care.
Education Background: 2 years Medical School at the University of SD,
Vermillion, SD 1952. BS Degree at the University of SD, Vermillion 1956. 2 years at Washington University, St. Louis Mo. 1959. 1 yr Rotation Internship St Louis & Duluth, MN 1960.
Residency: Board Certified in Family Practice since 1960. No residency
required at that time.
Where Dr. Munneke practiced medicine: 15 years at Clara City, MN 1960-1975.
1 year at Brookings, SD 1975-1976. Founded Family Practice Medical Center in Willmar, MN 1976, then had 8 years solo practice with addition of 2 Nurse Practitioners, then in 1984 Dr. Morris joined as partner, and FPMC has now grown to 8 Family Practice Doctors and 3 Nurse Practitioners.
Boards that Dr. Munneke has been involved with: Multiple committees for
Medical Academy Family Practice.
Board of Director in Medical Academy Family Practice. President of Medical Academy of Family Practice 1987-1988. Alternate delegate for MMA to AMA for 6 years and is now a full delegate for the past 5 years. Multiple committees of MMA including State Rural Health Committee and Committee of Mid-level Practitioners. Presently on the Legislative Committee and External Affairs Committee. Medical Director on West Central Medical Service Board for several years.
Changes in Dr. Munneke’s medical practice: Gone from small individually
owned business to a business owned or controlled networks.
Markedly increased paperwork, regulatory issues and less physician control and leaning to an assembly line type of medicine. Changed from purchaser standpoint from purchasing your own individual insurance choice to the company’s personal director deciding what and how much insurance the purchaser would have. Changes in development of technology, guidelines have improved the quality of health care and a gigantic increase in health care costs.
Family information: Dr. Munneke was married at age 20 to Alvina, a special,
wonderful wife who has provided much support for the past 47 years. Dr. Munneke and Alvina have three children, who all live close by.
Favorite pastimes: Riding Motorcycle. Dr. Munneke loves going to Sturgis
Motor Cycle Rally and has been doings so for the past 20 years. Going on a 5,000-7,000 mile trip to see the wonderful country that we live in, “just the 3 of us: me, myself, and my credit card”. Motorcycle trip with
his oldest son the last two summers. Collecting Harley Davidson, Terry Redlin Wild Life Prints, Dickens houses and Santa Clauses.
Plans for retirement: Selling off his collections to make room in their
home for an office space.
Continue as Medical Examiner for a couple more years. Spend time with his wife and family at the cabin. Play cards, whist & rummy with a yearly trip to Montana to play whist. Continue to go fishing with friends and enjoy his motorcycle.
Thoughts of Dr. Munneke from Ms. Sharon Ericson, MRHC Founding Executive Director:
Dr. Munneke was included in the first planning meeting for developing a network in April 1994.
He met with Mike Callahan and I and Dr. Elton Wing, and Dr. Richard Mulder, State Representative, of the Ivanhoe Clinic, also Ron Jensen from Weiner Memorial Medical Center of Marshall and George Gerlach of the Granite Falls Municipal Hospital and Manor. Dr. Munneke was the chairman of the steering committee that developed the Cooperative and conducted many meetings as we sorted through what a managed care response might be.
Dr. Munneke has said my favorite things about health care of all the people I've heard talk about rural health:
These aren't direct quotes, but the sense I got of his remarks.
- We keep thinking things won't come to rural America and then they do and then we aren't very happy.
We should try to figure out what is good for us in rural health and then work together to do it.
- People complain about this managed care, but the way I see it, under the old system we did things to people because we could and it made us money and
under this new (managed care) system, we don't do things to people because that's how we make money. When will we develop a health care system that has the best interests of the patients in mind?
- It’s always better to ride with your buddies - that's why we have a coop, so we can ride with buddies.
Dr. Munneke struggled with the utility of the coop and how it worked with his clinic and others.
He always told us to pay attention to what was good for the patients and then we would be doing the right thing. I think that's what kept his eye on the prize - what was good for patients. He didn't really want, for example to do diabetes care improvements - thought it was unnecessary. But when the FPMC ran their numbers, he got behind that project 100%.
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Dr. Lyle Munneke of Family Practice Medical Center of Willmar has been an active leader in the Minnesota Rural Health Cooperative since the
beginning of the Co-op in 1994, was the Co-op’s first and only Board Chairperson, and will remain Chairperson until his anticipated retirement in December 2002. We appreciate everything he has done for the
Co-op over the years and wish him the very best in his retirement. Thank you Dr. Munneke!
Director’s Corner
Health plan support: In addition to our valuable group contract negotiation services we provide other important health plan related services.
- We assist members with billing problems that they haven’t been able to resolve on their own by acting as a liaison with the health plans and we have
usually been successful dealing with stubborn problems.
- We provide centralized credentialing services for providers for all but Blue Cross Blue Shield and Medica and we are currently applying for that
capability with them. With centralized credentialing you save time and expense by completing one set of paperwork and enduring one site visit through MRHC rather then the hassle of paperwork and site visits from
each health plan.
- We also work with clinic members to fulfill the quality assurance (QA) requirements of the health plans with which we have contracted in a non-redundant
fashion. By doing QA together we have qualified for bonuses and withhold returns that paid our members $99,000 last year. MRHC staff also provide a great deal of coordination and direct information compilation
and reporting that would otherwise need to be done by each facility further saving each facility staff time and expense.
Buying Group Membership Opportunity
Many of our members have used the Co-op umbrella to achieve a membership discount in the AmeriNet buying group. AmeriNet (www.amerinet-gpo.com) is
a national buying group that sells most of the products that clinics and hospitals need at reduced rates. There is an annual membership fee is tiered for clinics with the minimum being about $1,600 and averages
about $300 per physician. Through the co-op any clinic can join at approximately $100 - $120 per physician per year. Members can easily save the amount of their annual dues within 1–2 purchases. Sign-up for next
year is early December 2002. Please contact us if you are interested.
MRHC equipment and videos you can use
- We have a Polycom SoundStation full duplex speakerphone (value $1,000) that you can borrow for free. Great for teleconference meetings.
- We have a new Epson PowerLite 50c multimedia LCD projector (value $1,700) that you can rent for $10 per use. We need to charge as the $500 bulb wears out
with use.
- We have a brief compliance training video (value $200) for rent for $10 per use. Great for annual training for clinics or hospitals.
Quality Corner
Our next Quality Council Meeting will be held on Wednesday, October 16, at 2:00 p.m. at the Chippewa County Montevideo Hospital. Annette
Kritzler from StratisHealth will be providing data and measurement education to our members. Plan now to take advantage of this free educational opportunity!
QI Projects Update:
- Diabetes Care – Baseline reports are past due.
Work on interventions, such as recall letters and printing out flow sheets for each chart. Keep up on entering data from current diabetic visits and add more patients into the system as you have time or as they come in to the clinic for an appointment.
- Clinic Mammography Project – Continue to measure data monthly and send the results to the MRHC. Work on interventions.
- Hospital Mammography Project – Continue to send 1st time mammogram data to the MRHC monthly. Results of 1st survey are past due. 2nd survey distribution period is Oct. 15 – Nov. 15, 2002.
Mendy Lange
Quality Manager
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