Texas Providers - WellMed Networks

THE WELLMED DIFFERENCE
•W
e focus on the health and well-being of people with Medicare providing proactive,
preventive coordinated health care
•P
hysicians practicing in our Care Model are able to spend more time with patients
to answer questions and explain test results
•W
e help provide affordable care to patients
•W
e help connect those who qualify with social and financial assistance programs
WELLMED
AT A GLANCE
George Rapier III, MD
Chairman and CEO
George M. Rapier III, MD founded WellMed in 1990 as a single clinic in the Medical
Center area of San Antonio, Texas. He focused on preventive care and strong patient
relationships instead of responding to the patient’s symptoms after they became ill.
•W
e offer health care guidance 24/7
the
WELLMED
NE T WORK
•E
xtended hours and walk-in times are available for patients in some areas
WELLMED CARE MODEL
The WellMed Care Model was developed by physicians as a way to better treat our
patients. We provide proactive medical care by monitoring them while they are healthy
so we can better identify their symptoms if they do become ill. Patients are the
foundation for everything we do at WellMed.
Through our WellMed Care Model, our doctors provide more personalized attention,
so our patients get more personalized care to live healthier lives.
Chairman and CEO
George M. Rapier III, MD
WellMed Footprint (Texas and Florida)
WellMed primary care physician and specialist locations – 98+
Contracted primary care physician locations – 1,248+
Contracted specialist locations – 2,760+
Total number of providers in the WellMed Network - 9,100+
OUR MISSION
WELLMED
CARE MODEL
ACCESS TO CARE & INFO
Our name, WellMed, is a daily reminder of our objectives as a company.
Our mission is to help the sick become well and to help patients
PRACTICE MANAGEMENT
• Healthcare for all
• After-hours access to medical providers
• Accessible patient & lab info
understand and control their health in a lifelong effort at wellness.
• Disciplined financial management
• Cost-benefit decision-making
• Facilities management
OUR VISION
PRACTICE-BASED
SERVICES
• Comprehensive care for both
acute & chronic conditions
• Prevention screening & services
• Ancillary diagnostic services
To change the face of health care delivery for senior patients by providing
HEALTH INFO
TECHNOLOGY
quality, proactive patient healthcare with a focus on prevention.
• Electronic medical record
• Electronic orders & reporting
• Evidence-based decisions
an INTRODUCTION
Provider Certifications/Specialties
Dermatology, Geriatrics, Cardiovascular Disease and Interventional
Cardiology, Family Practice, Hospital Medicine, Internal Medicine,
Neurology, Osteopathic Medicine, Palliative Care, Pain Management,
Podiatry and Podiatric Surgery, Rheumatology, Wound Care, and more
Patients
280,000+
CARE MANAGEMENT
• Comprehensive patient-focused
processes supporting providers in the
treatment of chronic and complex patients
in the effort to deliver successful
outcome-based care
• Wellness promotion
• Disease prevention
QUALITY & DataRAPS
• Physicians and nurses working
with healthcare analysts to
drive outcomes
• Evidence-based best practices
• Medication reviews
CARE COORDINATION
• Collaborative relationships–ER,
hospital care & specialist care
• Care transition, palliative care &
on-site social worker
• Patient engagement and education
•
•
•
•
to a NEW Level of Health Care
in the WellMed Network
INTEGRITY - Honor commitments made to patients and providers;
never compromise ethics
COMPASSION - “Patients come first”; provide a holistic approach
to care
RELATIONSHIPS - Collaborate with all health care providers to
improve the lives of patients and caregivers
PRACTICE-BASED
CARE TEAMS
Provider leadership
Effective communication
Patient participation
Health Coaches
INNOVATION - Improve efforts related to patient experience
PATIENTS
NETWORKS OF FLORIDA, INC.
www.wellmedhealthcare.com
© 2016 WellMed Medical Management. All rights reserved. 5/2016
OUR VALUES
A WellMed affiliated physician network.
CORPREC_ALL_CO110415
PERFORMANCE - Demonstrate value to patient in how we manage their
health; require shared accountability across health care providers
ABOUT THE COMPANY
WELLMED COMPANIES
WELLMED BUSINESS MODEL
CONTRACTED PROVIDER MODEL
WellMed is a physician-led healthcare delivery system serving 280,000+ patients in
WellMed Medical Management Inc. (WMMI), part of OptumCare™ – WMMI
GREAT COMPANIES GROW GREAT PARTNERSHIPS
Texas and Florida through primary care clinics, multi-specialty clinics, and contracted
is a “capitated, full-risk” Managed Service Organization (MSO) with an HMO structure.
medical management services. Most patients are Medicare-eligible seniors.
We assume full-risk for our patients’ health through percentage of premium arrangements
WellMed is a capitated, full-risk Managed Service Organization (MSO)
with an HMO structure. That means:
•WellMed manages risk in Medicare Advantage plans through a percentage
of premium arrangements with multiple payer partners. Simply stated, we are
responsible for managing the premium that insurance companies receive
from CMS for the provision of healthcare.
•We help patients who are diagnosed with chronic diseases to prevent
major complications and reduce hospital stays.
BECOME A CONTRACTED PHYSICIAN IN OUR WELLMED AFFLILIATED
NETWORK OF PHYSICIANS
•WellMed shares the rewards with our team members for successfully
managing patient care and maintaining healthier and happier patients.
In this partnership model, a physician with an existing practice enters into a
contractual agreement with WellMed. The features and benefits are as follows:
with multiple payer partners. This means we manage the premium that insurance
Headquartered in San Antonio, Texas, WellMed is an industry leader in medical risk
management, highly effective disease management and chronic care programs,
healthcare delivery services, and more.* With a growing roster of primary care
companies receive from CMS for the provision of health care.
WellMed Networks Inc./WellMed Networks Inc. of Florida (WNI/WNIF) (501(a)) –
Physician led and managed, WNI/WNIF are WellMed companies which accept the
providers and specialists in cardiology, podiatry, dermatology, rheumatology, neurology,
contractual healthcare insurance risk for contracted providers servicing the Medicare-
palliative care, wound care and hospital medicine, WellMed specializes in the complete
eligible population in Texas and Florida.
coordination of care for patients. WellMed’s contract entity supports more than 9,100
WellMed Medical Group, P.A. – A physician-led, physician-driven company specializing
Robert Graham Center examined health outcomes for tens of thousands of WellMed
eligible senior patients with a medical or financial need in several Texas and Florida areas.
seniors in the San Antonio area. The study found WellMed seniors, on average, are
Comfort Care provides this service to its members through WMMI contracts with select
“Given the invaluable resources WellMed provides
to its network physicians, it has helped grow my
panel size, patient volume and re-imbursements.
I can take better care of my patients with better
outcomes. WellMed’s staff is very professional,
enthusiastic and eagerly involved with its physicians
and patient care, which is very helpful. WellMed also
helps to educate physicians on the Medicare health
system unlike any other plan I have seen so far. It is
older and live longer than the 65+ population in Texas†.
Medicare Advantage health plans.
a win - win situation for both patients and doctors.”
contracted providers and their patients in Texas and Florida under its partnership
with select insurance companies.
in the complete healthcare coordination for patients in Texas.
WellMed Charitable Foundation – An independent, 501(c)3 non-profit organization
Our name, WellMed, commands respect and recognition for the work we accomplish
that supports seniors and caregivers in the communities we serve. Funding is raised by
by keeping patients healthy and informed with up-to-date medical information and
community donors and WellMed employee contributions
resources. In 2011, a federally funded, independent, peer-reviewed case study by the
Comfort Care Transportation, a WMMI entity – A transportation company catering to
In 2011, WellMed partnered with OptumCare™, one of the nation’s largest health
Redbird Wellness Clinic in Dallas, TX
and wellness companies to further expand WellMed’s healthcare delivery system in
existing and new markets. To that end, WellMed has acquired more than 50 practices
For more information visit
WellMedHealthcare.com/affliated-physician-network,
call 855-835-1431 or contact the person
who gave you this brochure
representing 45 clinics in Texas and Florida since 2012.
The WellMed Vision is to change the face of healthcare delivery for seniors by providing
M E DICA L GROU P
need from doctors who care about them. We accept traditional Medicare and
M E D I C A L
MANAGEMENT
healthcare options.
† Case Study of a Primary Care-Based Accountable Care System Approach to Medical Home Transformation.
Journal of Ambulatory Care Management 34.1 (2011): 67-77. Print.
•You maintain ownership of the practice
•You are not at risk for losses, but can share in surplus generated by
successful care management
•WellMed supports the comprehensive care management of select
Medicare Advantage health plan members
•Bonus compensation will be based on quality outcome metrics and a
shared risk pool (varies by market)
YOU’RE REWARDED FOR YOUR DEDICATION
You and your staff can earn extra compensation for achieving quantifiable results
based on our patient quality metrics. Each metric is assigned a weight, target
percentage, and a point value and is measured against a benchmark. Quality metrics
are measured and reported throughout the year and re-evaluated annually.
GROW PROFESSIONALLY AND PERSONALLY
Senior healthcare is a major growth area for the future. According to statehealthfacts.org
and the US Census Bureau, the Medicare-aged American population could grow
26% by 2020—up to 55 million people. WellMed is well positioned to continue to
grow its facilities, staff, and services to fill this growing need, providing new solutions
to address the health needs of seniors.
WELLMED—PHYSICIAN OWNED, PATIENT CENTERED
WellMed is physician-centric and primary care-driven, similar to an Accountable Care
Organization (ACO). As an early adopter of the ACO philosophy, we have continuously
demonstrated how our healthcare delivery system can reduce costs and improve care
while also enhancing your patients’ quality of life and even save lives.
contract with select Medicare Advantage health plans to help provide affordable
* Recognized by Inc. Magazine as among the fastest-growing private enterprises 2009-2011; awarded the DMA:
The Care Continuum Award for Disease Management program in 2008; recognized in Milliman Care Guidelines
for protocols for knee replacement surgery rehab in 2009.
The WellMed Care Model enables you to provide efficient, comprehensive, and proven
care techniques to treat the whole patient—physically, mentally, and socially.
quality, proactive patient care with a focus on prevention. Through the WellMed Care
Model, we specialize in helping our patients stay healthy by providing the care they
— Dr.
Anshul Agarwal
Founder and Medical Director
You probably became a doctor because you care deeply about people, their health
and well-being. At WellMed, we create partnerships with physicians like you by
offering the structure and the environment to grow your practice and enable you
to focus on all the reasons that first motivated you to become a physician.
N E T W O R K S, I N C.
NETWORKS OF FLORIDA, INC.