As you know, Health Net's greatest asset is people...from our employees and providers to Producers like you, and most importantly our members. As part of Health Net's commitment to improving our overall member experience, we are implementing a new initiative called "Every3." Every3 prioritizes Comprehensive Annual Physical Assessments for (1) every Medicare Advantage plan member, (2) every year, and (3) for every chronic condition.
As a face of Health Net, we are relying on our Producers to communicate the importance of the annual assessment and Health Net's commitment to deliver quality health care to our members.
The comprehensive annual physical assessment is a complete review of all past and possible future conditions that should be done annually for ALL Medicare members, even if they are healthy! Doctors will screen for common chronic conditions, like diabetes, chronic obstructive pulmonary disease (COPD) and heart disease - just to name a few. The doctor may also review medications the member is taking and establish a health maintenance plan designed just for them. There is no copayment for this exam.
The benefits of Every3 are clear... more frequent and comprehensive assessments for chronic conditions result in earlier identification and better management of chronic conditions. Early diagnosis, treatment and management of any new conditions should reduce the impact it has on the member's way of life, as well as improve the member's quality of life. The practice of going to the doctor only when ill can result in more invasive, complex and time consuming treatment.
Every3 is also very important to our providers. The percentage of members afflicted with a chronic condition is a key determinant of the health plan's Medicare Risk Adjustment (RA) score which sets Medicare payment levels to Health Net. Many of our providers in California are paid a percentage of this payment. By increasing Health Net's (RA) score, providers may benefit from additional revenue. We must fully document all conditions, for all members every year so that our members can receive focused and proactive care, our physicians are paid appropriately, and Health Net may continue to offer competitive benefits.
Please ensure that all members you come into contact with are aware of our new Every3 initiative. Encourage them to set an appointment with their primary care physician for their comprehensive annual physical assessment immediately following their effective date with Health Net.
Thank you for your assistance and your continued support.
If you are authorized to write under an FMO or GA, please contact your FMO or GA directly.
For Health Net product training information, or any other questions, please contact your dedicated Broker/Producer Services team at the numbers listed below.
CA
Call our National Medicare Broker Service Center at 1-800-708-7646, Monday through Friday, 9:00 a.m. to 5:00 p.m., PST (excluding holidays) with any questions. You may also email them at HN_MedicarePrograms@healthnet.com.
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