A grant awarded to the University of Nebraska Medical Center by
the Partnership for Quality Education, provides doctors in training —
medical residents — a first-hand look at managed care systems. Grants
were awarded to 64 academic health center and community residency programs
across the country through the Pew Charitable Trusts grant to the Partnership
for Quality Education, an $8.3 million initiative to train physicians to
provide high-quality, cost-effective managed care.
UNMC, which received a $9,000 grant, partnered with United HealthCare
of the Midlands, Inc., to offer three, third-year family medicine residents
a month-long look at managed care, said William Minier, M.D., principal
investigator of UNMCs grant. Deb McPherson, M.D., Gary Smith, M.D., and
Robin Bernard, M.D., elected to participate in the program this year, Dr.
Minier said.
The residents attended managed care training while continuing
to fulfill their residency responsibilities in teaching and patient care,
he said. Drs. McPherson and Smith completed the program in September; Dr.
Bernard will complete the training in December.
“It was really enlightening,” Dr. McPherson said. “You can learn
the system through a program like this or spend the first five years in
your practice trying to learn the system and the language. We sat in on
meetings, learned how the claims process worked, the appeal system and
the goals of the managed care companies, from the chief executive officer
to the customer service department.”
Dr. McPherson said it helped her learn the system so she can do
what’s right for her patients.
“We wanted to participate in the program because we feel it is
an outstanding way to help future physicians learn about all the benefits
managed care plans can offer,” said Cindy Barnowski, vice president, Health,
Quality and Customer Service, United HealthCare of the Midlands, Inc.
“Some managed care principles such as disease management, case
management and population-based medicine are also common to good medical
practice and should be part of a resident’s training,” Dr. Minier said.
“Managed care organizations have the opportunity to gather claims data
for research that can help provide information and feedback to physicians
so they can best care for their patients.”
Dr. Minier said he hopes the initiative can continue to provide
future physicans with a better understanding of managed care systems. About
100 million Americans rely on managed care practitioners for their health
care, according to Rebecca Rimel, president of Pew Charitable Trusts.
UNMC is the only public academic health science center in the state.
Through its commitment to research, education and patient care, UNMC has
established itself as one of the country’s leading centers for cancer research
and treatment and solid organ transplantation. More than $34 million in
research grants and contracts are awarded to UNMC scientists annually.
In addition, UNMC’s educational programs are responsible for training more
health professionals practicing in Nebraska than any other institution.
United HealthCare of the Midlands, Inc., in conjunction with United
HealthCare Insurance Company, provides health benefit plans to more than
240,000 Nebraska and Iowa residents. As of March 1, United HealthCare of
the Midlands holds a three-year full accreditation from the National Committee
for Quality Assurance (NCQA). It is the first plan in Nebraska and Iowa
to receive full accreditation from NCQA, an independent, not-for-profit
organization that evaluates managed care organizations. United HealthCare
of the Midlands parent company, United HealthCare Corporation (http://www.unitedhealthcare.com),
provides a full spectrum of resources and services to help people achieve
improved health and well being through all stages of life.