PPO Serve

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Putting GPs at the centre of healthcare.

We organise the team, IT System and fund management to assist with proactive care to GEMS patients.

How Does It Work?

Value-Based Care rewards practices for good outcomes.

We provide GPs with a practice transformation coach who manages a multidisciplinary team of nurse care coordinators and allied healthcare professionals that assist in providing targeted care to their GEMS patients.

Guidance

GPs thrive through value-based care with our guidance.

Proactivity

Our data-driven approach and risk stratification facilitates proactive care.

Support

We provide the team with a system to focus practice efforts.

Funding

GP practice remuneration rewards good patient health outcomes.

Signup Process

Join us and register your GP practice, today.

We invite all GP practices interested in providing holistic proactive care to their GEMS patients to apply to join our value-based care programme.

1
Check practice
suitability
We evaluate if your practice has sufficient GEMS members.
2
Let’s get in touch
Our team discusses the requirements that your practice needs to meet.
3
The SLA
Sign the service-level agreement, aligning your expectations with ours.
4
Getting started
We build a team support system around your practice for optimal patient care.
Improving Healthcare

PPO Serve has you covered!

From the application process to the facilitation and management of value-based care in your practice, we are committed to providing guidance and supporting you on your path to success.

Multidisciplinary teams

We provide nurse care coordinators and allied healthcare professionals and more who are managed by our coaches.

Patient management

Our Intelligent Care System offers shared patient information and proactive care plan recommendations.

Fund management

We manage the scheme contract, ensuring a stable income throughout the year, rewards and easy administration.

The Benefits

How do GP practices benefit?

Shared support
Better benefits
Smarter admin
IT support
Coaching
Coordination
Streamlined collaboration

Focusing on shared patient care by working together.

Collaborate and share local multidisciplinary resources with other practices in an environment that supports teamwork, and learn from Teams around the country.

Improved reliability

Enjoy consistent and preventative benefits

Consistent benefits ensure that practice revenue does not vary or run out at the end of the year and preventative benefits enable proactive clinical and social care.

Simple and efficient

Streamline and optimise practice administration

Don’t worry about billing or bad debt because the global fee is linked to the combined patient ‘disease burden’ budget and not a fee-for-service model.

Improved accessibility 

System-wide patient info with clinical IT support 

Our comprehensive Intelligent Care System provides useful summaries of patient information based on all of their medical scheme claims data.

Systematic support

Get the help of a practice transformation coach

Coaches are the interface between GPs, the multidisciplinary teams and us. They also liaise with the scheme for the team and undertake local marketing.

Coordinated care

Get the support of nurse care coordinators

Coordinators provide optimal care for complex patients, organise home visits, guide patients through the system, provide disease management support and more. 

Qualifying Criteria

How does a GP qualify?

Interested in joining our value-care programme but not sure if your GP practice qualifies? Here are some criteria points to focus on:

  • Number of GEMS patients

    To be suitable to join our value-based care programme, the patient base must consist of sufficient GEMS members*

  • Legal requirements

    GPs need valid registration with the HPCSA, professional indemnity insurance and other legal prerequisites.

  • Other requirements

    There are a few other criteria points that practices need to meet to qualify. Please view them below.

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*We are in the process of partnering with other medical schemes. For the time being, this programme is only available for GEMS members. 

Ongoing Support

Maintaining the foundation to deliver value-based care.

Once a GP has a basic structure in place to deliver value-based care in their practice, we provide the system to maintain optimal performance and efficiency.
Management

Our team becomes your team to manage GEMS patient care and scheme relations.
Feedback Loop

Our approach ensures improved communication with all stakeholders.
Focus

Our model puts GPs back into their central PHC role.
Reporting

We offer data reports that target patient interventions and clinical support.

Growing Our Network

Spreading value-based care across South Africa.

More GP practices are joining us on our journey to address our country’s dysfunctional healthcare system. The areas actively providing value-based care to GEMS patients in South Africa include:

  • The north of Pretoria
  • Alberton
  • Future areas to be confirmed
Register

GP Qualfying Criteria.

1. Population Health

Participating GP’s will need to have an basic understanding of the VCT model including:

  • Value-based care
  • Differences between FFS and Global fee
  • Population segmentation and alignment of effort vs need
  • Embrace the value of team-based care
2. Legal Requirements

All practices should be able to provide proof of valid registration with the HPCSA and indemnity insurance including:

  • Clinical record keeping according to the HPCSA guidelines
  • POPIA: Proper processes that demonstrate effective, personnel and information management; all documentation is completed and managed in line with legal/POPIA regulations
  • A minimum level of occupational and environmental health and safety processes are in place to meet legislative requirements
3. Infrastructure

Changing a delivery system requires certain minimum infrastructure. The premises should have:

  • Fit-for-purpose consulting rooms – as tested in the initial audit using assessment tools developed for purposes of the programme
  • Internet access, communication system and IT hardware to make use of the online Patient Management System (Intelligent Care System)
  • Additional space availability your VCT care coordinator to enable her to do her work (computer, admin, consulting etc)
  • A proper filing system should be used that demonstrates good record-keeping which is always available to the care coordinator
4. Remuneration

The practice should serve a minimum number of attributed patients to make it viable to work within the VCT:

  • A minimum of 100 patients from participating medical schemes/funders
  • Where multiple GP’s practice are in an association or partnership or employ locums (i.e. share patients) in the same location or multiple locations:
  • - ALL GP’s are obliged to participate in the VCT
  • - The practice will be responsible for outcomes of all doctors employed by them
  • - The practices will need to appoint a master practice
  • - This master practice will receive the monthly payment on behalf of the scheme to all GP’s in the practice
  • - The master practice will receive a monthly statement of all eligible patients, who they were allocated to and who they consulted
  • - The master practice will distribute the funds internally
5. Administrative Support

It is essential that practice administrative staff support the programme. The PPO Serve coach will provide training and support and the minimum requirements are:

  • Actively enrol patients into the programme
  • Explain the benefits to patients
  • Ensure patient contact details are updated regularly
  • Enable and allow care coordinators to access clinical Information (hard copies or digital)
  • Register and capture patients on ICS
  • Ensure no accounts are being rendered to patients for services included in the global fee

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