10 Key Elements of an Integrated Risk Bearing Organization (IRBO)

 

  1. PCP designation: Your plan keeps track of who your primary care provider (PCP) is.  Primary Care Providers include physicians with specialties in internal medicine, family practice, and pediatrics, and nurse practitioners and physician assistants.
  2. PCP engagement: Your PCP helps coordinate your care.
  3. Data sharing: Electronic medical records provide secure access to your health history, prescriptions, lab results and appointments to help your PCP and other providers keep track of your medical needs and make sure they are met.
  4. Low cost providers encouraged:  You have incentives for choosing low cost, high quality specialists and hospitals.  Your PCP and health plan will help you find the appropriate providers.
  5. Expanded hours and urgent care access:  Your providers will have expanded hours, including some evenings and weekend appointments making it more convenient for you with off hour urgent care needs.
  6. High level care for the chronically ill: If you have a chronic condition, your PCP will monitor and advise you all year long.
  7. Disease management: Your health plan will identify patients at risk for complications and will help you and your provider navigate your care and find out about best practices.
  8. Group visits: Patients with similar conditions sometimes meet together with providers for education, group interaction, support, self-management assistance, and direct patient-practitioner encounters. These types of visits include wellness programs for patients with weight-related issues, diabetes, or low back pain.
  9. Transitional care management: When you are released from the hospital to rehab or home, your treatment plan accompanies you.
  10. Essential reporting package:  Your health plan will help providers to help you by giving them timely reports on patients, their fellow physicians, and best practices.

This information provided by the Group Insurance Commission .