NAMM - The Midwest Leader in Healthcare Management
Providing Healthcare Management Services through Comprehensive Solutions and Proven Experience
Not just Management – Core Values in Action
NAMM - a national corporation that was invited to the Chicago Market in 1994 by five of the area’s top medical groups. These groups are still our clients today. Ninety percent of our clients have been with us for over ten years. These medical groups are a mix of Independent Physician Associations, Physician Hospital Organizations and physician clinics and practices. Why? NAMM develops your business with you. NAMM helps you grow with each opportunity. The majority of NAMM business associates are client referrals. Our reputation and proven track record translates into bottom line earnings for your group. Whether your goals are related to finance, operations or health services, we give you support through an unwavering commitment to your organization. Our experience speaks to NAMM’s core values in action.
Do What is Right...
Case History #1: IPA desired to expand Quality Improvement Program across the spectrum of patient care involving all providers in the group.
For this client NAMM developed and implemented a strategic program to achieve their organizational goals of expanding a Quality Improvement Program. This comprehensive quality program combined RN directed projects, including targeted member outreach, with trend and outcomes analysis against local and national benchmarks. We believe that improving quality will result in the most efficient health care delivery system. Our Health Services Programs are designed to assist your organization in managing the patient throughout all aspects of the healthcare system. Our member outreach programs satisfy a variety of goals from disease prevention to improving the care of chronic conditions.
Raising the bar with our clients and challenging the status quo has proven successful in achieving the highest honors and incentive available in the market today. Working collaboratively with physicians to make quality care a priority has allowed NAMM to offer a variety of solutions from Quality Management Specialists dedicated to strategy to Information Technology Solutions allowing for metrics that will support a customized solution.
Case History #2: Urban PHO sought to upgrade current operational processes used to keep large number of small practices in compliance with risk contracts.
Thorough Cost and Utilization analysis NAMM enables your organization to work with each physician practice regardless of size. Eighty percent of the practices hired by NAMM are small independent physicians seeking large physician practice solutions. Like other medical groups, this client recognized the need for a shared services management team in order to achieve economies of scale. Our standard electronic interfaces; including Electronic Funds Transfer, Electronic Referral Management Systems, Secure Provider Portal and EDI Data Exchange create an organized delivery system for your medical group. This helped our client achieve interoperability that ensures their care coordination, financial reporting and operational integration needs were not only met, but exceeded all expectations resulting in a sophisticated, automated and compliant environment.
NAMM has incorporated these functions within the business processes for all our valued clients. Today, we are diligently working to expand these core solutions that enable our clients to graduate to the current and demanding digital requirements. We are also providing for the foundation and infrastructure that will respond to tomorrow’s demands.
Set the Standard...
Case History #3: Independent Physician Association lapsing into debt contemplated dissolution prior to contacting NAMM.
NAMM was able to immediately respond to this physician group with a step by step action plan that brought them back to financial stability. Reimbursement and Expense audit, reinsurance recovery and financial planning were the keys to a solid recovery plan. NAMM’s Health Services team works in conjunction with our financial and business recovery team to implemented cost containment measures that adhere to the necessary, evidence based care guidelines while optimizing revenue and containing costs.
NAMM implemented improved processes for ambulatory management, emergency room utilization and inpatient case management including implementation of a hospitalist program. Standard metrics and trending provide for a comprehensive program that continually improves and responds to provider issues and allows them to maximize their revenue potential.
Case History # 4: Community Physician Hospital Organization needed a solid Customer Service Program in order to increase market share and attract additional health plan contracts.
NAMM knows that your medical group has two clients: patients and participating providers. NAMM has established countless processes and created multiple access points for our clients. First Call Resolution, available through our customer service unit allows members and providers to submit inquiries and obtain real time answers. NAMM understands that our trademark “high touch” philosophy is why our client relationships last through the changing Illinois healthcare market.
From Blue Cross Blue Shield Blue Stars to our URAC Accredited Utilization Management Programs to our Active Board representation in the Managed Healthcare Providers Association as well as participation in other industry associations such as Midwest Business Group on Health, NAMM appreciates how the accolades we earn go hand in hand with the partnerships we develop with our clients.
Strive for Excellence...
Case History #5: Physician Hospital Organization requested an updated incentive program designed to improve quality performance and inpatient management.
NAMM Currently manages over 100,000 HMO members distributing over $10 million in earnings to physicians annually. By implementing a variety of custom pay for performance incentive models, NAMM has encouraged physician groups to deliver cost effective and optimal care. Physicians facing a myriad of fee schedules and incentive plans look to NAMM to navigate the financial waters.
When the medical director for this client asked for modifications to the incentive program, NAMM reviewed links between pharmacy and quality metrics and added components for individualized physician inpatient management targets that enabled them to take advantage of new incentive streams while improving the care their patients receive.
Maintain Integrity and Trust...
Case History #6: Suburban Physician Hospital Organization sought to review longstanding contracts to evaluate against current market requirements, fee schedules and contract parameters.
At NAMM, your dedicated Medical Group Executive Director is committed to the viability of your organization. Contract negotiation and management are key components of the overall strategic plan we develop with you. Your Executive Director will collaborate with your physicians to capitalize on all available funds from every aspect of a health care contract.
NAMM contracting efforts have pinpointed areas unique to each medical group and worked collaboratively with the medical group and health plans to achieve equitable contracts with potentials for revenue that enable your group to maintain physician panels in multiple health plans.