Membership Information
The SouthWest Health Alliance:
Increasing the Value of Employer-Purchased Healthcare in the Southwest
What is the Southwest Health Alliance?
SWHA is a coalition of southwest-based employers, committed to creating value-based purchasing opportunities for its members. Its mission is to promote employer access to high quality, cost-effective health care by leveraging its collective purchasing power. Members include:
- Maricopa County
- City of Chandler
- City of Glendale
- Avnet
Affiliate Members are:
- Schering International
- Health Service Advisory Group
How can my company join SWHA?
Membership in SWHA involves a simple application process and is affordable. The application can be obtained by contacting SWHA. Dues are calculated upon the employer's number of benefit eligible employees in the Southwest region.
What are the benefits of joining SWHA?
Membership brings access to HealthEOS and its package of exceptional services and products, products that will enable employers to control costs and improve the quality of their employees' health care. Membership will also help employers
- Stay informed on health care quality, cost initiatives and employee productivity issues being embraced around the country
- Access educational seminars and publications
- Obtain information on key legislative issues
- Shape the research initiatives of the Alliance.
What is the HealthEOS?
HealthEOS is a multi-state provider network and medical data management company that provides a comprehensive package of products and services for employers to manage health care costs and quality. The package includes:
- The Care EngineSM Service that identifies ineffective and sometimes dangerous medical conditions/treatments and drug scripts and communicates that information to providers in the field on a 24/7 basis,
- A sophisticated central data warehouse of complete patient-centric medical records (medical/hospital claims, lab tests and values, drug prescriptions, and other medical notes, etc.) used by the CareEngineSM Service to improve care and outcomes and to re-price medical claims,
- A broad-based network of physicians, hospitals, labs, x-ray facilities, pharmacies and other ancillary services,
- A Pharmacy Benefit Manager to manage the utilization of pharmaceuticals and obtain the best discounts,
- Utilization Review, Case Management, and Disease Management
HealthEOS is an expansion of the MultiPlan/Wisconsin Preferred Provider Network (WPPN) and reflects a broadened scope of national products and services. HealthEOS is committed to working in partnership with employer coalitions across the country to develop solutions to the rising cost of health care and provide value-based products and services for employers.
How large is the Provider Network?
The provider network is the MultiPlan Arizona Network that consists of 6,400 providers, 1,194 facilities including 55 acute care hospitals. National Network coverage consists of over 139,000 PCP providers, 271,000 specialists, and 55,000 facilities including 3,099 Acute Care Hospitals in the MultiPlan National Network.
How does the Care EngineSM Service Work?
The Care EngineSM Service is a sophisticated computer system that mines the rich database of information from medical claims, pharmacy and laboratory sources on thousands of patients and organizes it into single patient file. The information is linked with supporting medical literature, protocols and standards of care. The Care EngineSM Service then:
- Triggers every patient case, in which there appears to be potential for clinical error,
- Stratifies high-risk patients and situations,
- Flags those cases for review and,
- Recommends appropriate intervention.
Staff physicians then determine the best method of informing each employee's treating physician, whether by direct phone call, faxed information or e-mail. Supporting medical documentation is provided as well.
How does Utilization Review (UR) work?
UR (or resource allocation and consumption management) can be provided by the HealthEOS UR group, which is accredited by the American Accreditation Healthcare Commission, also known as URAC. UR defines whether or not a service is necessary and is being performed in the proper setting. A determination is made by UR regarding the advisability of case management or disease management to be implemented.
How does Case Management Work?
Case Management is the coordination of resources required to manage very sick patients outside the inpatient setting. Specifically trained nurses (RNs) follow each patient to assist in transitions from one type of care to another. The Care EngineSM generates a list of potential case management clients.
How does Disease Management Work?
Disease Management involves compliance management for the chronically ill. The Care EngineSM Service selects patients for health risk appraisals and assessments. These patients are followed by RNs trained to remind and help patients comply with the standard treatment regimens. Current Disease Management identified by the Care EngineSM Service includes:
- Chronic Obstructive Pulmonary Disease
- High Risk Pregnancy
- Diabetes
- Hypertension
- Congestive Heart Failure
- Asthma
How can my company purchase the HealthEOS products?
HealthEOS products are available now. Call Tom Sawyer or Peter Cerchiara at 480-970-1724 for information on how you can lower the cost and improve the quality of the health care you offer your employees.
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