Patient
Choice
The Next Generation of Health Care Delivery Services
in
Milwaukee - Today
General Description
Patient Choice provides a consumer-driven health care services program where:
- Patients in Milwaukee County choose their doctors
- Health Care Professionals control their health care decisions
- Employers define and manage their costs
- Consumers make choices based on price and quality of care
Background
Patient Choice's unique health care delivery network model is based on Choice Plus, a consumer choice program originally developed in 1997 by a coalition of large employers in Minnesota known as the Buyers Health Care Action Group (BHCAG). Since 1997, the program has been successfully delivering results and has been recognized nationally as an innovative, leading edge approach, receiving media attention from a variety of prestigious business and industry publications.
A New Approach
The Patient Choice program differs dramatically from traditional HMO or PPO offerings. For example, in traditional managed care plans, costs are often controlled through adversarial negotiations with providers regarding reimbursement for medical services. The Patient Choice program lets physicians, hospitals and other health care providers set their own reimbursement levels.
Patient Choice is dedicated to enhancing the patient-physician relationship. We believe decisions about the care you deliver should be between you and your patient. In fact, we've designed our health care delivery network model to put you in control -- over your care management decisions; your fees; and your patient relationships.
Central to Patient Choice is the "Care System" model. A model in which health care professionals align themselves into networks called Care Systems. These Care Systems include primary care physicians, specialists, hospitals and other health care professionals and facilities.
Care Systems are free to organize and operate in ways they think are best for consumers. They have the power to determine their own network of providers, access procedures and care management philosophy. They are responsible for meeting patient needs and allow you to be accountable to your real customer -- the patient.
In addition, Care Systems set their own price for the medical care services they deliver. Their price to consumers is based on their proposed fee levels, combined with their own risk-adjusted utilization efficiency. This total cost is ranked against other competing Care Systems to determine its relative price to consumers.
The Patient Choice Advantage
Under Patient Choice, physicians and health care professionals:
Control prices to consumers. Annually, Care Systems determine their fees to deliver services. In the Patient Choice program, economic incentives throughout the continuum of care are aligned, eliminating onerous capitation risks.
Determine medical management. Under Patient Choice, physicians can focus on what they do best -- providing high-quality care. Since Care Systems determine their own access procedures and care management philosophy, there's no health plan looking over your shoulder. Care decisions are between physicians and their patients.
Are rewarded for delivering high-quality efficient care. In this program, physicians, hospitals and other health care providers are encouraged to market themselves directly to consumers. Care Systems that best meet patient needs are rewarded, as more individuals will choose to receive care from them. Program results have shown that Care Systems with lower costs and/or higher satisfaction ratings tend to gain membership.
Patient Choice Links
The following materials are in Adobe Acrobat format (PDF).
Care System Information
- Provider Add/Term/Change forms (PDF)
- Out-of-Care System Referral Approval/Denial Form (PDF)
- WPS 2006 Patient Choice Care System Administrative Manual
Compare Hospital Quality Care
Marketing Materials
Contact Us
- Contact Us about Patient Choice!
