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Residency

Residency. Program. Professional Background. Started in Managed Care - 1984 Managed FFS & CAP Systems FMC PPOs & IPAs Govt./Politics to Non-profit Medical Politics 5 Boards / 60 Physicians Privately Held Entrepreneurial for-Profit Company. Purpose of Visit. What is USA MCO

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Residency

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  1. Residency Program

  2. Professional Background • Started in Managed Care - 1984 • Managed FFS & CAP Systems • FMC PPOs & IPAs • Govt./Politics to Non-profit Medical Politics • 5 Boards / 60 Physicians • Privately Held Entrepreneurial for-Profit Company

  3. Purpose of Visit • What is USA MCO • Largest Private Self Developed PPO • Network Development Company for Carriers/Payers • Why USA Offers Residency • First Residents - 1994 • Convince Students of Value of MC Residency • Goal - 2 Residents In-House

  4. Other Affiliated Universities • Texas Tech • University of Houston Clear Lake • Texas Women’s University • University of Alabama Birmingham • George Washington University • Washington University • University of Missouri

  5. Evolution of PPO’s • Stockton, California • HMO Dominance in California - Late 80’s Early 90’s • Rationing Care Issue • Resurgence of Popularity of PPOs - Mid to Late 90’s • Major Consolidation of PPOs Nationally • Many Local, Regional PPOs Acting as Secondary Networks • Value Based Contracting – Will ACOs Replace PPOs?

  6. /Motorist Medical Network

  7. Some of Our Clients • United Healthcare • Mutual of Omaha • Cigna • Humana • Aegon

  8. USA MCO - Why Are We Different? • Involvement in Quality Initiatives • Accreditation – JCAHO – 1st & Only National PPO • Leapfrog Initiative • ACOs • Astra Merck Partnership Award • Direct Provider Contracts • Efficient Decision Making Process • Able to Create Market Opportunities/Niche Businesses • Tenacious, Resilient, Resourceful

  9. Why Tenacious, Resilient, Resourceful • USA’s Medicare Supplement Story

  10. Where Are We Going? • Fill in Provider Gaps in All Networks • More Primary & Secondary PPO Business • Evolve Medicare Supplement Program • Evolve Medicare Select Program • Get MedSupp/Select Clients to Use Other USA Networks • To ACO or Not to ACO

  11. Residency Program • Steps to Complete Residency • What Other Residents Have Done • With USA • Provider Contracting/Relations • Austin Resolutions • Accreditation • RFP • Marketing/Sales • Client Contracting/Account Management

  12. Residency Program - Continued • Outside of USA • Manage Provider Groups • Staff Medical Centers • Consulting Houses • Staff Public Policy Initiatives • Marketing/Sales

  13. Trinity HCAD Graduates of USA-MCO Residency Program • Justin Arthrell – Jan 2006 – Site Clinical Quality & Patient Safety Coordinator, Seton Hospital • Danny O’Connor – Jan 2005 – Manager, Deloitte Consulting in Washington, DC • Elizabeth Klier – Jan 2005 – Operations Manager, Seton Family of Hospitals • Vanessa Ruiz Thompson – Jan 2004 • Ben Chouteau – 2000 – VP Managed Markets at Kinetic Concepts • Clay Carsner – 1995 – Vice President and Chief Operating Officer, Seton Clinical Enterprise • Jeff Brocket – 1995 – CEO Texas Retina Associates • Cami Hawkins – 1994 – Managing Associate at Health Directions. Principal at Managed Care Solutions, LLC

  14. USA Offers Unique Opportunity

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