Kiana Mehring, MBA, director of strategic partnerships, managed care at Florida Cancer Specialists & Research Institute (FCS), discusses her role working in managed care and some of the new strategic partnership initiatives at FCS.
The Holistic Model of Care at Florida Cancer Specialists & Research Institute (FCS) looks at oncology patients from the vantage point of ensuring that services that enhance care delivery throughout the cancer journey, whether it's through care coordination, behavioral health, medical integrated services, research, social support, and more, says Kiana Mehring, MBA, director of strategic partnerships, managed care at FCS. She also discussed "gold carding," a practice that allows physicians who have demonstrated that they meet prior authorization requirements to gain rapid approvals for prescriptions.
Transcript
How is your role working with managed care on prior authorization, which seems to be a major concern for many oncologists?
We have begun working with our payer partners on gold carding initiatives, wherever possible. The benefit to gold carding is it reduces the administrative burden for both the provider and payer; it streamlines the process. Being gold carded really means that providers are already doing a great job when it comes to high value care in their expertise on therapeutics. So, therefore, the payers reward them for it. This recognition really allows them to streamline administrative processes and focus more on patient care as the priority versus doing the prior authorizations.
What are some key strategic partnership initiatives are programs that FCS has implemented as to support its patients and improve care?
FCS is launching a Holistic Model of Care. This places the patient, their family, and the oncologists at the center. It really is an enterprise-wide approach that we are putting through for all patients, regardless of the payer. This is going to measure quality metrics that are proven to bring high value care that reduces payer spend. Our new care model is going to look at oncology patients holistically and includes services that are going to enhance the quality of care that they receive, such as care coordination efforts, behavioral health, medically integrated services, such as medically integrated dispensing, and also molecular testing, research, social support, etc.
One thing we're also doing that I want to mention is we're partnering more with primary care providers, including MSOs [managed services organizations], IPAs [independent physician associations], and ACOs [accountable care organizations]. This really allows us to make sure that the patient’s primary care physician is involved in their care, and that we are collaborating with them to ensure that our patients receive the best care possible across the spectrum.
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