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About GLHP
Our Mission
We help people live healthier lives
Our Philosophy
GLHP is committed to ensuring that all members receive appropriate and timely, preventive, and episodic medical care. In order to achieve this goal, GLHP works with a network of physicians and hospitals providing high quality and cost effective care. Our Plan provides information to the provider, to produce cost effective outcomes and best practices.
GLHP is responding to the information requirements that drive the healthcare industry by pioneering the use of consolidating information from disparate sources to support proactive and episodic care, disease and case management programs, in support of the physician delivering healthcare. As managed care develops into the next decade, patient care data, its acquisition, organization into usable information, management, and analysis, will be the key to improved patient outcomes, and HMO success. Our providers and our members both require information to manage practices, patient care, and their family's health. GLHP is directing its resources to address the need for essential information for care management. Our providers, armed with information, are able to work more closely with patients to improve outcomes. That focus will ultimately have the greatest impact on medical expense savings. This is our brand of managed care.
Our Plan's long-term growth is dependant upon our being responsive to the needs of our customers, whether members, providers, or the State of Michigan. Putting the customer at the center of our solution will ensure growth and stability.
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Vision For Our Future
GLHP will be the preferred, best in class provider for government health care programs. Our partnerships will assist in fostering the compilation and provision of vital information to our providers, supplementing both the health care delivery and social service process, for the overall betterment of our member's lives.
By responding to our member's needs, GLHP is implementing initiatives such as in-home nursing, mass immunization administration, and education programs to improve in the quality of health care in our communities. Our relationships with various social service agencies within our communities are developing into programs to provide day care services, in-home outreach and medical education, to improve the overall health and well being of our community.
Our success will be based on:
The dedication and commitment of all our employees.
Empowerment of each staff member with information and a clear understanding of our vision to better serve our customers.
Continued demonstration of our dedication to our community and our employees by responding to ongoing changes in our environment.
Continuous performance improvement practices.
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Setting the Pace for the Local Industry
The goal of GLHP is to set the pace for Medicaid managed care in Michigan. Our first task has been to establish a positive relationship with providers through our authorization policies and prompt payment. Our emphasis on data and to obtain, manage, and disseminate information to the provider as a basis to successfully manage outcome-oriented care for our members within the most cost-effective means is unique in our industry.
We have made several initiatives the centerpiece of our business strategy that will assist the Plan in overall management of costs, in managing its network relationships, enhancing value for our state, and provider customers, creating value for our shareholders:
1. Case and Disease Management. A critical factor for GLHP's success has been the development of case and disease management programs. This component is the outreach tool for the Active Health data, to actively engage our chronically ill members by identifying service needs and developing processes to address those needs through case management and communications with our provider network.
2. Claims Process and EDI strategies.EDI and timely payment of claims are not only statutory and regulatory mandates (30 days on 90% and 90 days on 99% of clean claims), but an essential part of our strategy for achieving customer service. Aggressively reducing claims processing time has significantly and positively impacted our provider relationships. Implementing EDI capability for claims processing is also a legislative mandate and a critical strategic initiative. EDI claim submissions from providers will not only reduce our administrative FTE costs, but will also speed payment to providers who have submitted clean claims through an independent EDI claim clearing house.
3. Medical Economic Evaluation.GLHP has dedicated resources to medical cost data analysis, to analyze and report cost relative to revenue, county by county, by population of enrollee, by service, and by provider.
4. Provider Profiling Data. As our number one customers, providers need information not only about the care they are providing, but peer comparisons in treating similar patients and outcomes. Practice patterns on admissions, pharmacy, and best practices for cost-effective outcomes are essential areas of information that must be gathered, analyzed and shared with the providers on a regular basis. Through data comparison, we can continually update providers as to best practices and treatment choices in comparison with their peers.
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Page Last Updated on 6/16/2009 11:52:57 AM
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