One Network Makes Comeback While Another Is Just Beginning


John Marcille

Spring fever must have settled in early around here. You may notice two baseball references in our magazine and another in our online blog. The thought of baseball can warm the heart on a cold, snowy day. The blog item refers to a new forum where clinical executives can gather, kind of like the bar depicted in the TV show Cheers, where Sam Malone, a former Red Sox pitcher, served up various spirits to Boston patrons.

The first mention of baseball in this issue appears in our cover story. Contributing Editor Joseph Burns refers to the movie Moneyball in discussing why health plans are increasingly contracting with narrow networks of providers. Health care is like baseball, says Brett Morris of Health Net of Arizona, because officials like Morris are always trying to put together the best teams of providers, the “free agent” physicians and hospitals who can deliver high-value, low-cost care.

Not every provider can or should make the cut. Not in an era where the emphasis is on accountable care and patient-centeredness. As the consultant Paul H. Keckley, the subject of our Q&A, points out, clinical executives at health plans now have the hardest jobs, and are often the only voice with clinical training and experience in the room. They’re managers in every way.

Which brings us to our second baseball reference in a story announcing the launch of the Medical Directors Forum (MedicalDirectorsForum.com), the same one mentioned in the blog (www.managedcaremag.com). The analogy used is of baseball players sitting around discussing the art of hitting.

The online forum is a place where medical directors can talk with peers about many medical management topics. It’s also a source of governmental and many private companies’ guidelines that clinical executives sometimes have to consult to do their jobs. It’s somewhere they can go to get the encouragement and pick up a few pointers on matters of mutual interest.

Did you hear? Pitchers and catchers are going to be reporting any day now.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

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