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UCSF Stanford expands Brown & Toland to include Stanford doctors |
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UCSF Stanford Health Care completed a contract in mid-June to expand participation in the Brown & Toland Medical Group to Stanford faculty physicians and to the physicians with whom they subcontract, announced UCSF Stanford chief medical officer Bruce Wintroub. In the past several months, the independent practice association (IPA) has been actively enrolling selected community physicians in San Mateo County, Wintroub said. At this phase, he said, physicians are being credentialed so that they can be listed as Brown & Toland physicians in health plan directories. The effective date for Stanford's actual participation in Brown & Toland will be Jan. 1, 1999. A Stanford administrative task force, led by Amy Baldwin, director of prepaid operations, and Linda Cook, director of clinic administration, will work on the transition from Stanford's own management services organization to that of Brown & Toland. Areas to tackle before January include data system compatibility; credentialing, eligibility, enrollment and authorization; and billing, Wintroub said. Brown & Toland will form a Peninsula regional operating committee with four Stanford physicians and two community physicians who will be responsible for medical management issues, Wintroub said. Patricia Perry, UCSF Stanford's senior vice president for strategic development, said that while the agreement can be expected over time to increase referrals from primary care physicians outside of the Stanford network, she cautioned that managed care remains a relatively small fraction of the patient population seen by UCSF Stanford specialists. The IPA is structured to accept only full-risk HMO plans or point-of-service plans with a significant risk component. The UCSF Stanford Medical Group continues to be responsible for contracts for HMO referrals, preferred provider organization agreements, Medi-Cal and other government contracting. The integration of UCSF and California Pacific Medical Groups to provide full-risk HMO care in San Francisco through Brown & Toland has surpassed all expectations, growing from a combined total of 165,000 covered lives to 190,000 in a very saturated managed care market, Perry said. People who enroll with Brown & Toland for their HMO care can select a primary care physician from the community or the university and get needed specialty care from the physicians affiliated with either community hospitals or academic medical centers. Physicians and hospital services are paid in a consistent manner across the network, removing economic barriers to referrals. Peter Gregory, senior associate dean for medical affairs at Stanford, said: "The obvious success of this model for patients, for community physicians and for UCSF faculty made it much easier for Stanford physicians to reach agreement to execute its managed care contracts through Brown & Toland. We will have access to a much larger management services organization and our faculty will be able to receive managed care referrals from a larger number of physicians. Brown & Toland has worked hard to maintain reimbursement rates attractive to Bay Area physicians, and its popularity with consumers should ensure that it continues to grow and to play a significant role in the managed care marketplace." Perry said Brown & Toland is generating considerable enthusiasm among consumers. "They can enroll in HMOs, yet have the convenience of being able to choose a local primary care provider for routine care and the security of knowing that they can be treated by a top specialist." Gregory said he believes that the high-visibility partnership with Brown & Toland will underscore the mission and values of UCSF Stanford Health Care. "This is the first time that the playing field has been leveled in the managed care arena," Gregory said. "We are not competing with other specialists on price, because the price paid is basically the same throughout the system. We can now compete on what we have worked so hard to refine: access, service and quality. "Over the past three years, the Stanford specialty clinics have demonstrated significant, measurable improvements in service, and I hope our patients will find us easy to use." Brown & Toland representatives and the Stanford task force will provide more detailed updates to the faculty and medical center staff on administrative procedures and compensation structures over the next several months, Wintroub said. The name Brown & Toland honors two visionary San Francisco physicians: Charlotte Amanda Blake Brown, who established Children's Hospital of San Francisco, predecessor to California Pacific Medical Center, and Hugh Toland, an eminent teacher and surgeon who founded Toland Medical College, which became UCSF. |
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Chief Medical Officer, UCSF Stanford Health Care
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