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January - March 2004
Newsletter
Looking back at 2003:
- We distributed health plan withholds totaling $ 117,670.
- We distributed UCare gain-share “profits” totaling $583,275.
- We returned unused additional paid in capital to current and former members totaling $63,867.
- We had an approximate net income of $106,000 for 2003 pending year end audit adjustments.
- We successfully added two clinics and two hospitals with combined additional 18 physicians (21% increase) and 69 hospital beds (11% increase). This has helped us with additional capital via stock sales and
income via member dues. It also incrementally improves our contract negotiating strength.
- We have negotiated major improvements in two health plan contracts and reviewed several contracts from health plans new to the local market and deemed them not worth contracting with.
- We have added a new service to hospitals that allows them to outsource almost all of their privileging data collection work. Two larger member hospitals currently use this service.
- We have started performing payer audits for clinics and hospitals for members that are interested. This will compare what MRHC contracted health plan payers actually member paid clinics or hospitals vs.
what our contract say the health plans should have paid. MRHC staff will present the results in person and follow up directly with health plans on any variances found.
- We also represented members on PrimeWest Community Reinvestment Committee in working towards medical providers being the first in line for any profits and the development of a gain-share system.
- We hosted a local BCBS Provider Crossroads training session that 60 people attended.
- We held a strategic planning meeting in October to allow members to have direct input as to MRHC’s direction for 2004.
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West Central Health Care Purchasing Alliance Update. As mentioned previously it is in the very early stages of being
formed in our region. The 12 county area includes Traverse, Big Stone, Lac qui Parle, Yellow Medicine, Grant, Stevens, Swift, Chippewa, Douglas, Pope, Kandiyohi, and Renville. This is an effort to create a health
insurance product that will be affordable to small employer group (1-49 employees, i.e. farmers, small businesses) and will be locally controlled.
Chuck Ness of MRHC is a Co-Chair and Mary Rapp of ELEAH, Lyle Munneke MD former MRHC chair and physician at FPMC Willmar, Vern Silvernale former
Administrator at Johnson Memorial Health System of Dawson, and Mark Roisen of the Lac qui Parle Health Network are on the Board. We will remain involved in the process with the goal of creating a marketable product
that minimizes harm to local Hospitals and Clinics.
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MRHC Jan – Apr 2004 Meeting Schedule
- January 7 Medi-Sota Board Meeting Montevideo
- January 8 Contracting Committee Meeting Willmar
- January 13 Clinic Managers Meeting Montevideo
- January 19 Credentialing Teleconference
- January 21 Quality Council Quarterly Meeting Monte
- January 22 Compliance Quarterly Meeting Montevideo
- January 22 Regional Bio-Terrorism Meeting Marshall
- January 22 WCHCPA Board Meeting Benson
- January 22 Board of Directors Meeting Granite Falls
- February 3 Advantage GPO Meeting Watertown SD
- February 4 Medi-Sota Board Meeting Montevideo
- February 6-7 Medi-Sota Annual Trustee Conference
- February 12 WCHCPA Board Meeting Benson
- February 12 Contracting Committee Meeting Willmar
- February 14 Valentine’s Day
- Feb 18-20 MMGMA Winter meeting St. Paul
- February 23 Credentialing Teleconference
- February 26 Board of Directors Meeting Granite Falls
- March 3 Medi-Sota Board Meeting Montevideo
- March 9 Clinic Managers Meeting Willmar
- March 11 WCHCPA Board Meeting Benson
- March 11 Contracting Committee Meeting Willmar
- March 22 Credentialing Teleconference
- March 25 Board of Directors Meeting Granite Falls
- April 1 Contracting Committee Meeting
- April 7 Medi-Sota Board Meeting Montevideo
- April 8 WCHCPA Board Meeting Benson
- April 11 Easter
- April 15 Compliance Quarterly Meeting Montevideo
- April 19 Credentialing Teleconference Montevideo
- April 21 Quality Council Quarterly Meeting Monte
- April 22
Monthly Board Meeting & Annual Meeting at Prairie’s Edge Convention Center Granite Falls
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Visit our website for meeting times and places at www.mrhc.net.
If you need a user ID and password, please contact Chuck Ness
at (320)-564-9118 or cness@mrhc.net.
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Current Membership
Clinics
Allergy & Asthma Specialty Clinic, Willmar
Appleton Medical Clinic
Counseling Associates of West Central MN, Benson
Divine Providence Health Center, Ivanhoe & Minneota
ELEAH Medical Center, Elbow Lake & Evansville & Ashby & Hoffman
Family Practice Medical Center of Willmar
Glencoe Regional Health
Services, Glencoe & Stewart & Lester Prairie & Winsted
Hendricks Medical Clinic, P.A.
Ivanhoe Clinic
JMHS Clinic, Dawson & Boyd
Lac Qui Parle Clinic, Madison & Marietta & Bellingham
Marshall Eye Clinic
Minnesota Pathologists Chartered, Willmar
Montevideo Clinic, P.A., Montevideo & Clara City & Clarkfield & Milan
Murray County Clinic, Slayton & Chandler
Northside Medical Center, Ortonville
Peter B. Meier, M.D., St. Paul
Prairie Family Practice Renville County, Olivia & Hector & Renville
Prairie Medical Associates, Morris & Wheaton
Rice Institute for Counseling & Education, Willmar
Rose Center for Women, Willmar New Member
Sioux Valley Canby Campus Clinic, Canby & Minneota
Southwest Ophthalmology Associates, Marshall
Stanley C. Gallagher, D.O., P.A., Wheaton & Herman & Browns Valley
Tyler Medical Clinic, Tyler & Lake Benton
West Central Radiological Associates, Willmar
Williams IntegraCare Clinic, Sartell
Hospitals
Appleton Municipal Hospital & Home
Chippewa County Montevideo Hospital
Divine Providence Health Center, Ivanhoe
ELEAH Medical Center, Elbow Lake
Glencoe Regional Health Services
Granite Falls Municipal Hospital & Manor
Hendricks Community Hospital & Home
Johnson Memorial Health Services, Dawson
Madison Lutheran Home, Inc.
Murray County Memorial Hospital, Slayton
Ortonville Area Health Services
Redwood Area Hospital
Renville County Hospital, Olivia
Rice Memorial Hospital, Willmar
Sioux Valley Canby Campus
Swift County Benson Hospital
Tyler Healthcare Center
Weiner Memorial Medical Center, Marshall
Wheaton Community Hospital
Non-Voting Members (NV)
Great Plains Eye Clinic, Ltd., Sioux Falls -- NV
Hennepin Facility Associates, Minneapolis – NV
Lake Area ENT, Watertown, SD – NV
LCM Pathologists, Sioux Falls, SD – NV
Lyle Munneke, MD, Willmar -- NV
Michael B. DeBrule, Marshall – NV
Rick L. Nissen, MD, Bloomington – NV
Willmar Foot and Ankle, Willmar - NV
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Health Plan Status. We continuously review the contracts we hold on our members’ behalf and try improve reimbursement or contract
language or both. We are currently working with the following plans:
- HealthPartners
- Medica
- UCare
- PreferredOne
- TLC Advantage PPO & Work Comp
- USA Managed Care
If you are approached regarding a health plan contract, just send us a copy and we will review it for either MRHC or provide you an analysis if
MRHC declines to participate with the health plan.
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2004
MRHC Board of Directors
Brendon Cullinan, M.D., Montevideo Clinic - Chair
Larry Grong, D.O., Lac qui Parle Clinic– Madison– Vice Chair
Leroy Meyering, CFO, Rice Memorial Hospital – Secretary /Treasurer
Mark Huntington, M.D., Northside Medical Center – Ortonville
Romulo Kabatay, M.D., Appleton Clinic
Fred Knutson,
Administrator, Chippewa County Montevideo Hospital
Dale Kruger, Administrator, Tyler Healthcare Center
Richard Mulder, M.D., Ivanhoe Clinic
Tom Richter, Administrator, Madison Hospital
Alan Roiseland M.D., Family Practice Medical Center-Willmar
Dean Slagter, Administrator, Renville County Hospital
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Focus for 2004 will be to continue to build membership and to continue to work on improving health plan contract language and reimbursement. Two main benefits come from increased membership: 1) decreased member dues per physician and hospital bed; and 2) more bargaining power with vendors and health plans.
Goals for 2004
- Incorporate Critical Access Hospital reimbursement into relevant hospital health plan contracts.
- Communicate updated contract information to all members on a quarterly basis.
- Implement one ICSI guideline per year in coordination with the various MRHC contracted health plans.
- Maximize MRHC membership in a 90 mile radius of Granite Falls. Consider members outside the 90 mile territory. Try to grow membership income from new
members by $30,000 per year.
- Survey members on interest in a local multi-day CME opportunity with significant credits available (e.g. 15 hours credit over 3 day weekend).
- Re-evaluate services offered to our members by surveying members on what services we provide that they want us to continue and what new services they
would like us to provide.
- Continue to develop new income streams to decrease dependence on member dues.
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Quality Corner
Paula Soine replaced Mendy Lange as Quality Manager in late October. Among the many projects she has been working on since she started are the
Payer Audits and the overwhelming response by facilities for the analysis; a total revision of the clinic patient satisfaction surveys (samples were sent out this week to quality managers); and wrapping up the 2003
Adult Immunization and Diabetes Quality projects. Final analysis on those quality projects was sent out to participating facilities last week. 2004 Quality project topics will be decided on at the Jan. 21st Quality meeting. Clinics and hospitals will now have separate meetings beginning with this meeting. Paula is looking forward to attaching faces to all the people she’s been talking to on the phone the last few months!
psoine@mrhc.net or 320-564-9118 ext 12
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MRHC is creating a video/book library for use by its members. Included are the following:
Videos available for rent for $10 for a couple of weeks. (Ave. cost $275 each) great for annual training
- “Understanding Corporate Compliance” run time 13:08 minutes
- “Understanding Corporate Compliance: What’s Your Role?” run time 15:00 minutes
- “Physician Compliance: It’s Not An Option” run time 18:37 minutes
- “EMTALA Compliance: What Every Employee and Physician Must Know 2nd Edition” run time 16 minutes.
Books available for rent for $5 for a couple of weeks. All have supplemental CDs
- “Hospital Compliance Program Assessment: Your Tool For Measuring Effectiveness”
- “Medicare Medical Necessity: A Guide to Accurate Reimbursement and Full Compliance”
- “Compliance Troubleshooter: Tackling the Top 10 Compliance Challenges”
- “Ready, Set, Comply!: Games, Quizzes, and E-mails for Fun and Easy Compliance Training”
- “EMTALA Training Handbook for Physicians and Other ED Staff”
- MGMA “Cost Survey: 2003 Report based on 2002 Data”
- MGMA “Physician Compensation and Production Survey: 2003 Report based on 2002 Data”
- Older Cost Survey, RBRVS, and other books are also available to use for free.
Also available for $10 per use rental is an Epson PowerLite 50c LCD projector. Laptop to use with this projector is also available at no cost.
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