The case study concentrates on the roles of medical directors in giant HMO companies and insurers. The case study specifically focuses on gatekeeper contracts in HMO. Dr. Bethe is one of the medical directors in Xtra Mile firm. The case study informs that all the directors in the firm report to different levels in the organization.
The case also provides information on the criteria used by the firm in hiring its medical directors. In addition, the case study contains the firm’s database and information on the approaches it uses to motivate quality performance among physicians providing healthcare within the network (McLaughlin, Johnson & Sollecito, 2011).
How Dr. Bethe spends his time and why the medical director position is a high risk job for him
Dr. Bethe does not follow his time schedules because he is often interrupted by urgent projects that he is required to attend to. Although he is organized, he cannot follow his timetable. For example, in the previous month he was unexpectedly required to oversee recruitment of new employees, supervise auditing, and address supervisory and human relations issues in the firm (McLaughlin et al., 2011).
The medical director’s position is a high risk job for Dr. Bethe. He manages a number of healthcare providers and primary healthcare physicians within the network. If he does not exercise prudent management, the giant healthcare insurance firm may suffer huge financial costs. He is expected to act as a link between his firm and healthcare providers and physicians.
Making a bigger difference at Xtra Mile
Dr. Bethe is confident of making a bigger difference at Xtra Mile than he could have at the local integrating system. He asserts that he is prepared to handle and manage a large portfolio issues in the healthcare insurance firm because he has experience on patients’ behavior towards healthcare policies.
He is quite realistic about this because healthcare insurance providers succeed on the basis of customer satisfaction from their clients. They also succeed on the basis of the number of healthcare providers and primary healthcare physicians within their networks. He is aware of these facts, and he believes that Xtra Mile has great opportunities in the future (McLaughlin et al., 2011).
Quality healthcare is essential in healthcare providing institutions. Patients remain loyal to their institutions depending on the quality of care they get from these facilities. The incentives proposed for primary healthcare physicians will go a long way in motivating the healthcare professionals to offer quality care to patients within the network.
It seems that the incentive system is designed to motivate professionalism among primary healthcare physicians. The system will impact on the primary healthcare physicians by motivating to offer professional healthcare to their patients. They will work towards this because they will be expecting to be rewarded on the basis of customer satisfaction.
Advice to Dr. Bethe and his time allocation
In the future, Dr. Bethel should focus on implementing his plans for the firm. He seems to be so interrupted with urgent projects that he cannot do much in his time schedule. He should use delegation tactics so that his juniors could perform his duties in his absence. This will ensure that things will be running even when he is interrupted by urgent projects.
Advantages of an integrated database
An integrated database in a healthcare insurance provider ensures that all information regarding policyholders, healthcare providers and physicians could be accessed with a lot of ease. Analysis of crucial data is also made easier than when using different databases in a firm.
Xtra Mile’s coverage of physicians in Georgia market
Xtra Mile has incorporated a good number of physicians with proven quality care experience in Georgia market (McLaughlin et al., 2011). The firm has a reputation in good relations with its physicians within its network. With its new incentive system, more physicians might be attracted to work with the giant firm.
McLaughlin, C., Johnson, J., & Sollecito, W. (2011). Implementing continuous quality improvement in health care. Sudbury, MA: Jones & Bartlett Publishers.