Medical Consumers Empower Themselves with American Medical Consumers
February 26, 2008
When illness or injury requires all that medicine has to offer, does your healthplan make it available?Or only some? Your next step and perhaps your life depend on the answer.When medical decisions determine your fate – make sure you’re using AMC
The American healthcare delivery system increasingly emphasizes consumer-directed healthcare, requiring the consumer to pay more and to make more critical healthcare decisions.
Healthcare has become like so many other consumer goods: “Some assembly required!”
But, the more you must do on your own, the more you are likely to need help. More consumer choices and more consumer decisions mean more problems.
If you are desperately sick or injured you are more vulnerable than ever, precisely when you need the best American medicine can offer. You wonder, will you get the best? Very possibly not! So, what’s the next step?
Information is not enough. You need a partner. But who? And where or when?
AMC is ready to partner here and now. Through the AMC Next Step program, we are shaping consumer-directed healthcare, not merely responding to or fostering it.
Whether you’re employed or not, AMC can help you with your health care needs in ways that employers cannot.
Click here to find out more about AMC Next Step right now! Or, if you have specific questions about how AMC help you with medical decision-making, send us an e-mail: nextstep@medconsumer.com.
Services Overview
Next Step for Individuals
Next Step for Employers
Next Step for Providers
Next Step for Brokers and Healthplans
Next Step for NF and Other Disorders
Company Profile
Contact Us
AMC Next Step
Next Step for Individuals
If you or a close family member has recently had the diagnosis of a serious, catastrophic illness or injury, you will want to join the dozens of AMC clients who have called us on their own to utilize the evaluation and coaching activities of AMC Next Step. If you feel vulnerable or frustrated or overwhelmed or any combination of these feelings, AMC Next Step can help. Let us help you sort out the next step that’s best for you and your family, so that you and they can get on with the healing, which is what medicine should be all about in the first place. Helping with the next step is what we do best.
This approach to improved health care is ideal for all persons, including the self-employed and those without a healthplan. Rather than have to sort through the quagmire of a complex healthcare delivery system while you’re most vulnerable and compromised, we can help you sort out what to do next, help guide your next step.
For details about Next Step, please scroll down to “Next Step: An Idea Whose Time Has Come.” The fee is $200.00.
Next Step for Employers
Most employers are genuinely concerned about the health and well-being of their employees. In the ongoing balancing of operating expenses with the healthcare needs of employees, however, assistance to the employee often involves simply making available a healthplan. Now employers can do more. They can see to it that their employees understand the full range of health care choices and opportunities both within the available healthplans and beyond them, even if no healthplan has been provided.
The point is to ensure that employees burdened with serious, catastrophic illnesses or injuries (affecting themselves or close family members) are able to understand and use all of the available resources to get on the road to healing that allows return to work as soon as possible. The employer pays a capitated rate for all eligible employees and the employees use the service on a strictly confidential basis according to each employee’s personal needs.
For details of how Next Step works, please scroll down to “Next Step: An Idea Whose Time Has Come.”
Next Step for Providers
A significant number of providers are simply not familiar with all of the possibilities that a person with a catastrophic illness or injury may want or need to take into account. Referral of such patients to AMC Next Step will ensure that the patient is given a full and unbiased set of choices about how to proceed further – that is, take the next step. Patients referred through a physician would be eligible for discounted fees.
For details of how Next Step works, please scroll down to “Next Step: An Idea Whose Time Has Come.” For financial details please contact AMC directly.
Next Step for Brokers and Healthplans
Brokers can offer AMC Next Step to their clients who purchase a healthplan. This option increases the value of the healthplan policy by ensuring that the client, in the event of a subsequent serious, catastrophic diagnosis is not limited to the healthplan’s contractual limitations in terms of identifying and understanding all of the medical options, both within and beyond the healthplan. Similarly, healthplans can directly add value to their products by affording their members direct and immediate access to AMC Next Step, a neutral third-party evaluation of the various choices and options available. Our experience to date has been that at least 50% of the time we encourage AMC Next Step clients to consider their in-plan options as being a reasonable or best choice.
For details of how Next Step works, please scroll down to “Next Step: An Idea Whose Time Has Come.” For financial details please contact AMC directly.
Next Step for Neurofibromatosis
For persons with or at risk for neurofibromatosis, AMC, The Neurofibromatosis Institute and Dr. Vincent Riccardi can help in a variety of ways. First, with an established diagnosis of NF1 or NF2, we evaluate the situation and give direct feedback in terms of our Needs Assessment and Resource Identification services, as well as in terms of AMC Next Step. Second, to confirm or eliminate the diagnosis and to devise a comprehensive management and follow-up plan consultation with Dr. Riccardi is always available. Consultations do not require a physician referral.
For details of how Next Step works, please scroll down to “Next Step: An Idea Whose Time Has Come.” For information about Needs Assessment and Resource Identification and consultations please contact AMC directly.
Next Step: An Idea Whose Time Has Come
Medicine – the intersection of business and health care – accounts for
many of life’s critical cross roads and the need to take a drastic next step.
Critical Cross Roads
For a person who has been generally healthy and then suddenly has a serious, perhaps life-threatening medical condition, the situation is characterized by surprise, disappointment, frustration and even anger and despair. Indeed, finding yourself without warning to have a catastrophic disorder, such as a broken neck, cancer or multiple sclerosis, is devastating. When patients find themselves at such critical cross roads – in the midst of vulnerability and overwhelming complexity – the recurring and most important question is “What’s the next step?” Trying to determine what to do next preoccupies you, adding to your vulnerability and detracting from responsibilities to your job and to your family. It’s made all that more frustrating when you can’t be sure if your doctor and healthplan have business or health care as their highest priorities in your taking the next step.
AMC Next Step
American Medical Consumers has developed a program to help patients plan and actually take the next step when they find themselves at one of life’s serious medical cross roads. AMC Next Step is specifically suited to patients, not to the limitations of the healthplan. Although directed at patients, AMC Next Step does not involve the practice of medicine. Rather it is an administrative service, similar to the already familiar “utilization review,” this time from the patient’s vantage point.
* Verify. First, we verify the diagnosis and prior management by review of medical records made available by the patient.
* Expand / Reinforce. Second, we identify practitioners and facilities (eg, hospitals, laboratories, centers of excellence) that are likely able to provide the best second opinion and thereby optimally advise the patient of the next step. AMC may expand the choices to beyond the healthplan or reinforce the decision to continue relying on the healthplan and its resources.
* Support. Third, AMC provides direct telephonic support to patients as they sort through their various options and finally take that next step.
* Monitor. An additional optional element of AMC Next Step is the literal direct monitoring of the progress of patients to enhance their expectations and minimize the occurrence of the so-called “medical errors” that account for some 80,000 deaths a year in the United States.
Consequences of Next Step
There are important potential consequences for both the patient and for the patient’s employer (presuming that AMC Next Step is an employer-sponsored job benefit).
* Due Diligence. The patient and family members want to know that they have done all they possibly can to ensure the best outcome.
* Optimize Patient Health / Outcome. Patients want to focus on the best health care and not on the contractual and other limitations that may detract from the best outcome.
* Minimize Patient Out-of-Pocket Expenses. If AMC directs the patient to well-respected authorities and institutions, the patient and family can potentially avoid redundant consultations, evaluations and treatments, as well as unnecessary delays and unnecessary travel.
* Minimize Time Off From Work. The best outcome means a healthier, happier patient and a more readily available, more productive employee.
* Address Healthcare Delivery Industry Weaknesses. By insisting that the focus be on health care expertise and not simply on business contractual limitations, a clear message is sent to the healthcare delivery industry about where the priorities should be.
COMPANY RESOURCES
The AMC system of medical resource management helps the American medical consumer obtain the best health care for the medical resources at his or her disposal. The AMC system of medical resource management combines an extensive consumerism experience with an equally extensive experience as a healthcare industry insider to provide a unique focus on medical consumer satisfaction, safety, savings and efficiency. In order to do this, we provide information, improve communication, facilitate access and deliver a personally tailored strategy to implement all three effectively.
Direct to Consumers – Choice Selection and Decision-making
We provide SERVICES intended to provide satisfaction (in terms of health outcome and a sense of having executed due diligence), cost savings and an efficient approach to health care through evaluation and coaching.
o AMC Next Step helps medical consumers take that next step when challenged by a catastrophic illness or injury. For example, a recent diagnosis of cancer or multiple sclerosis should lead to the use of AMC Next Step. The charge for this service is $200.00 for individuals, although an employer may provide it as an employment benefit.
o A somewhat less intense service involves Needs Assessment and Resource Identification keying off a less than catastrophic health problem and/or decision-making about a particular situation. For example, the need to find a particular type of specialist warrants the use of this service. The fee is $50.00.
o An intense Record Review is available for deciding how to pursue a claims dispute, filing a grievance, considering a lawsuit or for satisfying oneself that due diligence has been exercised. The fee is usually $200.00, but can be somewhat higher for especially complex cases.
o Involvement as an Expert Witness may be appropriate in some lawsuits as determined by the consumer’s own legal counsel. Hourly rates apply, determined on a case by case basis.
Direct to Consumers – Medical Error Monitoring
A new service – available both to individual medical consumers and to employees whose employers purchase AMC Next Step for them – involves literal monitoring of the patient while undergoing health care inpatient and outpatient procedures. Third party monitoring adds another dimension to minimizing inappropriate procedures and medical errors. The reason for requesting monitoring could be either the patient’s condition (e.g., stroke, broken hip, asthma), a specific event (e.g., surgery, chemotherapy, physical therapy, MRI scan), a particular setting (e.g., surgicenter, hospital, skilled nursing facility, rehabilitation) or other special circumstances (e.g., language, multiple disorders, away from home). Fees are determined by the details of the situation. Please call 800-836-5AMC for further information.
Direct to Consumers and Providers – The NF Institute
Vincent M. Riccardi, MD, President of AMC, is also a well-known scientist and clinician for the group of disorders known as the Neurofibromatoses, particularly the disorders NF1 and NF2. Patients and families with NF1 or NF2 or concerns about them may wish to use AMC’s non-medical services described above as Needs Assessment and Resource Identification, as well as the AMC Next Step program. They may also arrange for Neurofibromatosis Clinical Assessment (diagnosis, prognosis, genetic counseling and treatment) by Dr. Riccardi. Physicians, nurses, genetic counselors and other healthcare providers may also call for support of their care for patients with or at risk for neurofibromatosis. Please call 800-836-5AMC for further information.
Direct to Providers, Payors, Employers and Others
As described in AMC Next Step, employers can provide their employees with the benefit of a program designed to enhance the quality and timeliness of health care delivered and afford a more rapid recovery and return to a more ordinary life style and job productivity. Other parties, including physician groups, health insurance brokers, healthplans and various self-interest groups, may also find this a rewarding benefit of membership. AMC also offers to providers, payors, health insurance brokers and healthplans specifically tailored services designed to address efficiency and productivity, dispute resolution, grievance processing, utilization review, claims review, credentialing and career guidance. Please call 800-836-5AMC for further information.
Company Profile
Mission
The mission of AMC is to empower medical consumers by making the shift to consumer-directed health care meaningful and beneficial, helping them to save money and to improve their health. AMC was founded to deal with one issue – MEDICAL CONSUMERISM – based on the primacy of medical consumers realistically partnering with their doctors.
SHORT-TERM GOAL: To minimize the financial and health liabilities of patients, particularly those with severe and chronic disorders.
LONG-TERM GOAL: To improve the American healthcare delivery system by modernizing it to a knowledge-based collaboration between doctor and patient, in contrast to contract-based superimpositions on both doctors and patient.
History
AMC was founded in November 1992 as a California company with a nationwide impact. This company is presently a wholly owned subsidiary of the California corporation, The Neurofibromatosis Institute, Inc. Since its founding, AMC has engaged over 2100 clients. As healthcare delivery industry insiders, we have helped individual customers to
* Obtain access to enhanced health care
* Decrease medical bills
* Pursue grievances and lawsuits
* Improve relations with doctors and healthplans
As well, we have provided direct assistance to numerous employers, practitioners, medical groups, healthplans, scholars, journalists, government agencies and self-help groups. In short, AMC is an established leader in medical consumerism.
Background
Consumers are potential or actual purchasers. In order to obtain medical services and medical products, we must purchase them. In short, in order to obtain medical services, we all must be medical consumers, though there are different types, that change from time to time: patients, caregivers (non-professional givers of care) and simply purchasers. Understanding and utilizing the consumer approach is one of the most important ways of maintaining and improving your health and well-being.
AMC exists in order to make life more realistic for medical consumers in a changing world; likewise for doctors and other participants in our health care delivery system.
The American health care delivery system is undergoing revolutionary changes. Many people talk as if the revolution resulted from the intentions and plans of managed care organizations. The real revolution has been initiated by the medical consumer. Managed Care, as such, is not the issue. The issue is “contract medicine,” making health care decisions through contract language rather than on the basis of medical necessity determined by your doctor. Plain and simply, AMC believes that the medical consumers’ medically necessary needs are more important than contract language. “Doctor, can you help to the fullest extent of your knowledge and abilities?” These words are both an assertion and a call for assistance: a request for the doctor to do what he or she does best. They contrast with a deceptively similar question: “Doc, what does my health plan pay for?” The tragedy – and the basis for medical consumerism – is that often the doctor doesn’t appreciate the difference between these two questions.
Problems in the healthcare delivery system represent an opportunity to serve the medical consumer and to improve the system. AMC provides the skills and tools for both tasks.
WHEN A DECISION HAS TO BE MADE, YOU MUST CONSIDER WHETHER
THE BENEFITS DECISION MEASURES UP TO THE MEDICAL DECISION
Leadership
The President of AMC: Vincent M. Riccardi, MD, MBA
Vincent Riccardi has been educated, trained and served as a faculty member at six medical schools, including Harvard, Baylor College of Medicine and UCLA. His research and teaching have focused on health care delivery, clinical communication and genetic disorders. He has a national and international reputation characterized by capability, dedication and integrity.
He has been involved in the full breadth of medical practice.
* Leadership roles in both private practice and academia.
* A specialty pediatrician and internist, involved with all ages, newborns to elderly.
* Commitment to the whole-person, holistic, approach of genetics.
* The entire gamut of medical decision-making as a neurofibromatosis specialist.
He has first-hand experience with managed care, the business of medicine, the economics of laboratory diagnostics and specialty-based comprehensive evaluations.
* Master of Business Administration (MBA) degree received in 1993
* Performing the managed care activities of a Medical Director, as well as Utilization Review, Quality Assurance and Credentialing
* He is especially well-read in the literature of health care reform, patient rights and medical consumer advocacy.
He developed, implemented and operated innovative health care delivery systems.
* The Colorado-Wyoming Regional Genetics Program, now in its 34th year.
* The Baylor College of Medicine Neurofibromatosis Program, begun in 1978.
* He pioneered the use of computers and telecommunications to provide health care information directly to medical consumers.
* He has been a key contributor to the founding and functioning of disease-specific patient advocacy groups, including the Texas Neurofibromatosis Foundation and The Neurofibromatosis Institute.
He has been a medical consumer: Treatment and rehabilitation for a broken neck.
CONTACT
American Medical Consumers
5415 Briggs Avenue
La Crescenta, CA 91214
Voice: 800-836-5AMC
Fax: 818-957-4926
nextstep@medconsumer.com
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