Proactive MD

Common Employer FAQs

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FAQs

Common Employer FAQs

Overview


How is Proactive MD different than other onsite clinic providers?

Simply put, Proactive MD is not an onsite clinic provider. While we do operate onsite Health & Wellness Centers as a part of our total offering, these centers are just one piece of our transformative healthcare model.

We also offer Care Beyond the Walls™ by staffing each clinical team with a Patient Advocate who connects patients to the care they need and providing access to the nation’s only Smart Care Centers to help patients manage complex and chronic conditions. Using our proprietary analytics platform, the Patient Advocate and clinical team drive patient engagement, focusing their efforts on real patient data and population health concerns.

Our Health & Wellness Centers serve as the hub for patient interactions and for primary care services, but we come alongside patients and support them through the entire continuum of care both inside and outside the clinic. Through this comprehensive model that addresses complex conditions as well as the social and behavioral determinants of health, we are able to truly impact the cost of care and improve patient health.

Our Pricing Predictability

Cost


How can the Proactive MD model bend the healthcare cost curve?

We are better equipped than our competitors to bend the healthcare cost curve because we offer a more complete solution. First, unlike any of our competitors, we have a solution for your most complex and costly patient diagnoses. It is estimated that a small percentage of your patient population accounts for up to 90% of your healthcare spending, yet most onsite clinic models provide no services or chronic condition management for these patients. Our model not only provides these patients with access to high-quality, appropriate care at negotiated rates but also supports their ongoing recovery and wellness through our Patient Advocacy services.

But that’s just one way that we bend the cost curve. We also use our proprietary analytics platform to reach the right patients at the right time to prevent and manage critical health incidents. We use these same analytics and our Patient Advocacy services to create higher patient engagement, which allows us to better manage health conditions and reduce your specialist costs. Finally, we guide patients through the entire continuum of care teaching them to become better consumers of health, which results in more effective use of the healthcare system (lower costs!) as well as improved patient outcomes.

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How does Proactive MD control costs without compromising care for complex medical conditions requiring specialty care?

We believe in Care Without CompromiseTM—even when that care extends beyond the walls of the traditional onsite clinic. We’re unique in our ability to manage complex medical conditions while still containing costs. Most onsite clinic vendors don’t offer any solutions for patients who require specialty care, and so they aren’t truly able to impact the rising costs of healthcare. Proactive MD maintains an exclusive partnership with Edison Healthcare, giving employees access to the nation’s only Smart Care health network. This network is comprised of leading specialists who will confirm diagnoses, optimize treatment plans, and choose the best medical centers for major surgeries. Through this partnership, Proactive MD can ensure that patients with complex needs are receiving the most cost effective, appropriate care and the most successful possible outcomes. In addition, we offer chronic condition management and address the social determinants of care through our Patient Advocate, improving patient wellbeing and lowering costs for employers.


What does fees at risk mean?

Fees at risk refers to the percentage of fees that an onsite clinic vendor is willing to tie to their performance guarantees. While many vendors boast that they place 30%-100% of their management fees at risk, what they don’t tell you is that those management fees typically equal about 2%-7% of their total fees. In contrast, Proactive MD operates in a transparent way, putting all service fees at risk—which typically equals 20% of our total fees.

What is included?

Services


What kind of services will Proactive MD perform?

Proactive MD has pioneered an Advanced Primary Care model that empowers physicians to practice broad-scope primary care onsite. Patients can come to our Health & Wellness Centers for everything from routine annual check-ups and health screenings to nutrition counseling, acute care, and vaccinations.

Services


What is Advanced Primary Care?

An Advanced Primary Care practice focuses on high-quality care and improved health outcomes rather than volume-based clinic measures. The Advanced Primary Care model empowers providers to Care Without Compromise™ and enables them to practice medicine the way they trained. Physicians get to spend more time with patients and practice broad-scope primary care in-house instead of referring patients to specialists for care they can provide. In fact, an Advanced Primary Care practice maximizes reverse referrals to keep costs low. When a patient does require specialist care, an Advanced Primary Care clinic delivers high-quality care coordination, remaining connected to and involved with the patient throughout the entire spectrum of care.

Advanced Primary Care models make the system more accessible and understandable for patients. Our Proactive MD Health & Wellness Centers practice this level of care, providing personalized, compassionate, informative, and affordable support when navigating the healthcare system.

Reporting and Account Support


How often will I communicate with my Account Manager for concerns, changes and partnership improvements?

You are welcome to communicate with your Account Manager as often as you need to—and you can expect your Account Manager to reach out to you as well. Proactive is more than just part of our name; it’s our promise. We guarantee high-quality service and fast response times.


What support will Proactive MD provide for my organization on an ongoing basis?

Because Proactive MD prioritizes comprehensive, high-touch service, each Account Manager serves far fewer clients than our competitors. The low Account Manager to client ratio enables the Proactive MD account management teams to proactively communicate with each client. In addition to providing a yearly Health & Wellness Calendar, the account management team works with customers to establish an annual Account Management Calendar that outlines regular onsite and telephone meetings.

These meetings proactively tackle any potential issues and keep your team informed of the Health & Wellness Center metrics, current events, and upcoming programs/events. Examples from the Account Management Calendar include bi-weekly calls between the Proactive MD Account Manager and the client, monthly metric reviews, and quarterly meetings.

In addition, we offer ongoing communications, ad hoc reporting, special events and engagement initiatives, and integration with and support for your organization’s events—all customized to your culture.

This high-touch customer service approach results in an average of 30 encounters per year with each client.


How does Proactive MD interact with services outside of their health center?

Proactive MD is always working to improve and innovate in the healthcare space. We maintain relationships with other forward-thinking healthcare providers so that we can provide the best outcomes for our patients. We work in coordination with other providers and follow-up personally with patients who have received care outside of our Health & Wellness Centers to ensure our patients understand their treatment plan, know what will happen next, and have all the resources they need.


What type of reporting can I expect?

Proactive MD offers extensive reporting capabilities that are customized for each client. The client and the client’s consultants receive a login with real-time access to Health & Wellness Center dashboards, where the client can see clinical value trends, population risk trends, and utilization and encounter trends. Proactive MD is also investing heavily in technology to deliver transparency tools that will help the client and their consultants gain even greater insights into their patient population. These tools include features such as an interactive custom query engine, real-time clinic utilization tracking analysis (de-identified data), and expanded and enhanced TPA/carrier integration reporting.

Examples of specific reports we provide to our clients include:

  • Effectiveness of clinical quality, care coordination, and patient experience improvement measures
  • Individual clinician performance Individual clinician performance compared to book-of-business
  • Clinic-level performance compared to book-of business
  • 360-degree view of de-identified patient medical claims, gaps-in-care, pharmacy claims, wellness program engagement, network performance, referral rate, and care plan compliance.

Guarantees


What are your service and performance guarantees?

We offer four service and performance guarantees that actually matter and work together to bend your healthcare cost curve: ROI, Patient Engagement, Chronic Condition Management, and Service.


What’s included in my fixed monthly fees?

Most onsite clinic vendors use a pass-through, cost-plus pricing model that places performance risk and all financial variability back on the client. Proactive MD offers a comprehensive fixed fee program pricing structure that includes labor, Patient Advocacy services, supplies, professional fees, technology services, marketing, and management fees.