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Care Systems
In the Patient Choice Program, health care providers organize themselves into patient-focused networks called "Care Systems". Each Care System includes primary care clinics, primary care physicians, specialists, hospitals, and other health care professionals and facilities that work together to provide a full range of health care services to you.
When you enroll in Patient Choice, you select a Care System that best meets your needs. Each covered family member may choose a different Care System.
Knowing your Patient Choice Care System is important because:
- Care Systems are accountable to you for the quality and cost of the services you receive.
- Important consumer information, such as consumer survey results and cost, is reported by Care System.
- The payroll contribution you make toward the cost of your coverage may depend on the cost group your selected Care System falls into.
Care System Cost Groups
Patient Choice has collaborated with area health care providers to create a
tiered network program that puts you and your provider in control.
Care Systems participating in the Patient Choice program determine their own
pricing. Through a unique "tiering" process conducted by Patient Choice, Care Systems
are analyzed each year on measures of cost, quality and performance, then
grouped into low, medium and high cost groups. Care Systems that manage
their patients most effectively and price themselves competitively are
available to individuals at a lower cost.
Cost groups do not signify lower- or higher-quality care or service. They
are used to help you understand how Care Systems compare to one another and
may affect the amount you contribute towards the cost of your coverage--less
for cost group I, more for higher cost groups II and III.
View 2008 Care System Cost Groups
View 2007 Care System Cost Groups
Comparing Care Systems
Check out the Care System Comparison Guide
to help you choose the Care System that will best meet your needs.
It's chock full of information to help you compare Care System cost,
quality and service including capabilities, care processes, clinical
outcomes and consumer survey results.
Care System Web Sites
It's not always possible for Patient Choice to alert members to all of the
benefits of belonging to a specific Care System. If you would like to
learn more about the programs and services that may be available through your
Care System, check out their web site. To view a Care System web site,
click on the corresponding link below.
(Note: Some Care System web sites may include providers who do not actually
participate in the Patient Choice program. To search for a
participating provider, please refer to the Patient Choice directory.)
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