Physicians Health Network

“Sparrow health system (shs) is the parent and sole member of physician health network and has 100% ownership.”

“The board members elected by the board of directors are ratified by the board of directors of sparrow health system.”

“The board members elected by the board of directors are ratified by the board of directors of sparrow health system. Decisions by the board of directors of physicians health network may be subject to the approval of the sparrow health system board of directors.”

“Copies of the 2013 form 990 are reviewed by management. Once management completed its review of the form 990 copies were provided at the september 2014 board meeting for all board members to review and comment on.”

“1) corporate compliance sends out the conflict of interest policy and questionnaires to all voting board members and the executive team annually. 2) all disclosures are received and reviewed by corporate compliance. 3) all disclosures are given a resolution code and presented to the ceo and governance committee of the board. 4) all board/committee level disclosures are provided to the respective board chair and executive liaison to ensure issues can be addressed on a transactional level (i.e. If a vote is required on a transaction involving an interested person).”

“The process for determining compensation for the ceo of the organization involved the following: utilizing the compensation committee, independent consultants, reviewing other similar organizations' 990s, compensation surveys, and final approval by the shs board of directors, as well as finalizing the salary package with a written employment contract.”

“The process for determining compensation for officers or key employees of the organization involved the following: utilizing the compensation committee, independent consultants, reviewing other similar organizations' 990s, compensation surveys, and final approval by the shs board of directors, as well as finalizing the salary package with a written employment contract.”

“The governing documents, conflict of interest policy and financial statements are made available to the public as follows: the governing documents of php are submitted to the department of insurance and financial services (difs). Those are publicly available to interested parties. The conflict of interest is available through sparrow health system (parent of phn) by request to the sparrow compliance officer.”

“All lines left blank are not applicable to the organization.”

“Quality managed care products at a reasonable cost for its members. Physicians health network and physicians health plan (php) are wholly owned by sparrow health system. Php is primarily a commercial hmo and also operates three subsidiaries, php insurance company (phpic) a commercial insurance company, php familycare (phpfc) a michigan medicaid managed care plan and php service company a third party administrator. All staffing functions and reporting are accomplished through the use of the same staff as php. Unless specifically noted, all references to php apply to php, phpic, and phpfc. Phps service area includes the michigan counties of ingham, eaton, clinton, shiawassee, montcalm, gratiot, ionia, and isabella. Phpic offers products across michigan. The familycare product is available to medicaid enrollees in eaton, clinton, ingham, ionia, montcalm, and shiawassee counties. The michigan department of community health (mdch) and the department of insurance and financial services (difs) approved a service area expansion of phpfc into isabella county effective january 1, 2012. As of december 31, 2013, there were approximately 31,900 enrollees in phps commercial hmo, 12,600 in tpa, 10,900 in phpic, and 17,600 enrollees in php. Php also operates the state of michigans pre-existing condition insurance plan called hip michigan. This program was discontinued on june 30, 2013. The physicians health plan network is approximately 761 primary care physicians, 1,021 specialty care physicians, 378 allied health professionals, and 313 organizational providers that include 30 hospitals. Php contracts with various hdns who provide healthcare services to members. Phps commitment is to develop and deliver quality managed care products at reasonable costs for its members. Phps success in managing health care is due in part to the extensive network of participating providers in the hdn network. The hmo/hdn contractual arrangements allow php to arrange for healthcare to patients covered by the state of michigans medicaid benefit plan. This arrangement allows the members to access a wide variety of independent providers within each hdn including physicians, hospitals, pharmacies, skilled nursing facilities, and allied health professionals. Php members may also receive care for services from a nonparticipating provider if such referral is recommended by an hdn participating physician and the service required for treatment, as determined by hdn, is not available within the hdns network. Php offers a variety of healthcare programs, or products to groups and individuals. Php offers choices that provide coverage within the network of contracted hdn providers, limited coverage outside of the php network, various levels of deductibles, co-payments, and coverage limits, all of which are designed to be responsive to customer needs. Php measures the quality of care provided to its enrollees through annual review of indicators such as: - disease management program participation and outcomes, - quality of care concerns, and - hedis measures: the health plan effectiveness data and information set (hedis) is a group of nationally recognized measures of health plans performance in a variety of clinical and non-clinical areas. Php uses the effectiveness of care measures to determine progress and improvement in areas such as: diabetes, asthma, depression and follow-up after mental health admissions, breast and cervical cancer screenings, use of beta-blockers after heart attacks, child and adolescent immunizations, cholesterol management, controlling high blood pressure, smoking cessation, prenatal and postpartum care, and treatment of childhood respiratory infections. Php measures the quality of service provided to its enrollees by the review of performance measures related to: - access and availability of providers, - enrollee complaints and appeals, - customer service telephone access performance, and - member assessment. The consumer assessment of healthcare pr”