| Launch of the Hospital Information Service for MAAF and MMA |
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| Tuesday, 25 November 2008 19:11 | |||
November 2008 - Novembre 2008 - MAAF et MMA launch their Santéclair platform, a unique and innovative information service concerning quality and price in public and private healthcare facilities.Unique in France, this hospital information service allows MAAF and MMA policyholders to obtain information about fees for given surgical or obstetrical acts in any region in France as well as the quality of the healthcare facility in which these acts are to be performed. Accessible by Internet or by phone, it will be put in place in these two mutual insurance companies in the beginning of 2009. It is currently difficult for a patient to find his way in the medical system and choose the hospital in which he will be treated. Very often he does not have access to reliable qualitative criteria on which to base his choice; moreover he does not have an objective analysis of the fee that he will be asked to pay for his surgical intervention. Because of this lack of information and transparency, he often has no choice but to pay excessive fees without knowing if they are justified or not, and goes for treatment in a healthcare facility that is close to home or one that has been recommended by his general practitioner. This new hospital information service, accessible on line or by phone, offers three key functions for MMA and MAAF policyholders: - Analysis of quotations in real time, - Direct access to the list of best healthcare facilities specialized in the surgical or obstetrical act in a pre-defined geographical zone, - Access to different quality indicators used to calculate the global score of the healthcare facility. Sur Internet, depuis la page d’accueil de l’application, l’assuré a la possibilité d’obtenir les réponses recherchées par 2 points d’entrée principaux : This new hospital information service, accessible on line or by phone, offers three key functions for MMA and MAAF policyholders: - Analysis of quotations in real time, - Direct access to the list of best healthcare facilities specialized in the surgical or obstetrical act in a pre-defined geographical zone, - Access to different quality indicators used to calculate the global score of the healthcare facility. Via the home page of the application on Internet, the policyholder has the possibility of obtaining responses using two main key phrases: * “I have a quotation" corresponds to the situation where the patient has obtained a quotation of the medical fee that will exceed reimbursement levels by his surgeon, in compliance with the October 2008 decree for all medical acts costing over 70 Euros. Using this function, the policyholder will be able to analyse his quotation in real time and obtain the following information: - The fee agreement for the surgical act entered - The sum that will exceed this fee expressed in a percentage - The average fee charged for this act in the region of reference as well as the amount that exceeds the fee agreement compared to the average - The percentage of acts carried out without exceeding the fee agreement in the region of reference - The extra amount the policyholder will have to pay depending on his insurance. Once he has all of this information, the policyholder will be able to go directly to the list of the best medical facilities performing the given surgical act and see if the hospital he has selected is in the list, as well as its score. In all over 3,000 surgical and obstetrical acts have been evaluated in this way. * “I don't have a quotation,” the second way to access this service, allows the policyholder to obtain the ranking of the best public and private medical facilities in a given geographical zone for a given act. This list was drawn up using data from PMSI (Medical Programme of Information Services) using multiple quality criteria. Hence, for surgery: the volume of acts performed, their frequency, the average hospital stay, the reputation of the medical facility for this intervention, and the technical difficulty of the act as compared to the type of facility. For maternity wards: the frequency of multiple births and the transfer rate. Only facilities with a score equal to or exceeding 12 are included in this list. The policyholder has the possibility of accessing different quality indicators used to make up the global score and to know just how it was calculated by clicking on a hospital or medical facility in particular. Finally, in the Internet version, this service will have many other functions, such as: - Printing a document for health professionals with key facts. Policyholders can also use this document when a quotation is being renegotiated. - On-line aides to explain the meaning of terms (fee agreement, medical expenses over and above reimbursement) - Hospital services - Access to the historic of research by the Internet user and its analysis over a period of the last three months. This new Web Hospital Information Tool (WHIT) will be rolled out in the private pages reserved for MAAF policyholders in the beginning of 2009, and can also be consulted using the new Santéclair telephone platform. For MMA, policyholders will be able to access this service in the beginning of 2009 using the new platform of telephone information "GPS Santé" and on Internet in the second quarter of 2009. With this new Hospital Information service tool, MAAF and MMA allow their 1.8 million health care policyholders the possibility of accessing better and more cost-effective surgical and obstetrical care. * For MMA Health care policyholders, GPS Santé (a consumer service number) will be able to answer all queries concerning rules, prevention, and medicine. It will help to navigate in the health care system, and offers assistance services that are the best adapted to policyholder's needs
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