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Our Structure
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Physicians Health Plan was formed in 1980 by the Lansing community physicians and Sparrow Hospital with the goal of providing quality health care. In 1983, they expanded to three other markets using an Independent Practice Association (IPA) structure for local risk. The three markets included:
In 1998 the Physicians Health Plans collectively created a forum for the four PHP health system owners to develop statewide strategy, called the Shared Services Organization (SSO). In 2000, each PHP site obtained separate HMO licensure to enhance the local autonomy of community-based care. The Jackson location (Physicians Health Plan of South Michigan) received its license on March 13, 2000. The Muskegon location closed in 2000. The Kalamazoo location closed in 2005. In 2007, the remaining PHP's underwent a system transition to upgrade technology and processes. Today PHP consists of the following:
- PHP Shared Services Organization (SSO)
- PHP of South Michigan* (Jackson)
- PHP of Mid Michigan* (Lansing)
Today, the PHP Shared Services Organization performs the following centralized services for all three PHP plans:
- Sales Administration (Member packet coordination, Contract Administration)
- Policy & Procedure Coordination
- Information Technology Support
- Administrative Technology
In 2007, PHPSM members have access to more than 1,000 primary care physicians and specialists, as well as hospitals, urgent care facilities, and participating pharmacies. PHPSM is locally owned and operated. PHPSM performs the following services in its local community:
- Sales and Marketing
- Enrollment and Billing
- Network Management
- Care Coordination
- Quality Management/Improvement
- Finance and Accounting/Analysis
- Compliance and Regulatory Reporting
If you have questions about the history of PHPSM, please feel free to contact our Customer Service Department. Our Representatives will be happy to assist you.
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Excellence Happens Here
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The National Committee for Quality Assurance (NCQA) awarded Physicians Health Plan of South Michigan its highest accreditation status of Excellent.
NCQA is an independent, non-profit organization that assesses and reports on the quality of the nation’s managed care plans. Physicians Health Plan of South Michigan’s accreditation status – the highest possible level – is based on a voluntary review of how a health plan ensures that its members are receiving high quality care.
The NCQA Accreditation survey process includes on-site and off-site evaluations of over 60 standards and selected HEDIS®* performance measures conducted by a team of physicians and managed care experts. A committee of physicians analyze the team’s findings and assign an accreditation level based on the performance level of the plan being evaluated to NCQA’s standards.
An Excellent Accreditation is only awarded to plans that both meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement and have HEDIS® results in the highest range of national performance.
Physicians Health Plan of South Michigan is pleased to have received an Excellent Accreditation.
*HEDIS® is a registered trademark of NCQA.
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