2018 Sharp Premier Provider Network Overview

Total Page:16

File Type:pdf, Size:1020Kb

2018 Sharp Premier Provider Network Overview 2018 Sharp Premier Provider Network Overview Physicians • Hospitals • Urgent Care Centers • Pharmacies • Other Facilities Sharp Premier Provider Network Medical Groups At Sharp Health Plan, we understand the importance of selecting a network that fits your lifestyle and budget. As a member, you’ll join a family of award-winning medical groups, physicians and hospitals dedicated to meeting your health care needs. The Sharp Premier Provider Network offers access to Sharp HealthCare physicians and medical groups conveniently located in central San Diego County.1 Sharp HealthCare is San Diego’s most comprehensive health care delivery system, recognized for clinical excellence. With Sharp Premier, you will receive the most cost-effective premium rates within the Sharp Health Plan portfolio and have access to more than 1,100 physicians, including Primary Care Physicians and specialists. Sharp Rees-Stealy (SRS) This medical group offers a network of more than 385 physicians, including Primary Care Physicians and specialists. Admitting hospitals include Sharp HealthCare facilities and Rady Children’s Hospital. SRS physicians are located throughout San Diego County, including: • Carmel Valley • Frost Street • Mt. Helix • San Carlos • Chula Vista • Genesee • Murphy Canyon • San Diego • Del Mar • La Mesa • Otay Ranch • Scripps Ranch • Downtown San Diego • La Mesa West • Point Loma • Sorrento Mesa • El Cajon • Mira Mesa • Rancho Bernardo Sharp Community Medical Group (SCMG)2 This medical group offers a network of more than 720 physicians, including Primary Care Physicians and specialists. Admitting hospitals include Sharp HealthCare facilities and Rady Children’s Hospital. SCMG physicians are located throughout San Diego County, including: • Alpine • El Cajon • National City • Chula Vista • Imperial Beach • Point Loma • Clairemont • Kearny Mesa • Santee • Coronado • La Mesa • Tierrasanta • Downtown San Diego • Lakeside • University City • East San Diego • Mira Mesa 1 Service area does not include all San Diego County ZIP codes. Employer group headquarters location must be within the Premier service area. To see if your business qualifies for this product at the preferred premium rates, please ensure that your company is headquartered within the Premier service area. 2 Excludes SCMG Graybill, SCMG Graybill Temecula, SCMG Inland North and SCMG Arch Health Medical Group. Hospitals Sharp Premier provides significant coverage with access to Sharp hospitals across San Diego County, including: • Sharp Chula Vista Medical Center • Sharp Memorial Hospital • Sharp Coronado Hospital • Sharp Mesa Vista Hospital (no emergency services) • Sharp Grossmont Hospital • Rady Children’s Hospital • Sharp Mary Birch Hospital for Women & Newborns Urgent Care Centers Sharp Health Plan members have access to Urgent Care Centers across San Diego County. Please visit sharphealthplan.com/urgentcare to learn more about the Urgent Care Centers affiliated with Sharp Premier. Pharmacies Sharp Health Plan partners with San Diego-based MedImpact, the nation’s largest independent, privately owned pharmacy benefit manager, serving more than 37 million members nationwide. When you join Sharp Health Plan, you have access to hundreds of pharmacies, including: • Albertsons Sav-on Pharmacy™ • Rite Aid® Pharmacy • Costco® Pharmacy • Sharp Rees-Stealy Pharmacy • CVS/pharmacy® • Vons® Pharmacy • CVS Pharmacies located in Target® stores • Walgreens® Pharmacy • Independent neighborhood pharmacies • Walmart® Pharmacy • Ralphs® Pharmacy Find a doctor Visit sharphealthplan.com and click “Find a doctor” to see if your current doctor is in one of our Plan Medical Groups, or to find one that fits your needs. Consider us your personal health care assistant (858) 499-8300 or 1-800-359-2002 8 a.m.– 6 p.m., Monday through Friday [email protected] sharphealthplan.com.
Recommended publications
  • Sharp Chula Vista Medical Center Pgy1 Pharmacy Residency Program
    SHARP CHULA VISTA MEDICAL CENTER PGY1 PHARMACY RESIDENCY PROGRAM June 28, 2021 – June 24, 2022 PROGRAM GOALS Sharp HealthCare is a not-for-profit integrated regional health care delivery system based in San Diego, California. The Sharp HealthCare system is comprised of four acute-care hospitals, three specialty hospitals, two medical groups, and a proprietary health plan, in addition to hosting a full spectrum of inpatient and outpatient facilities and services. The Sharp Chula Vista Medical Center Pharmacy Residency Program is an ASHP accredited program that sits at the clinical and technological forefront of hospital pharmaceutical care. Residents will have an opportunity to gain hands-on clinical experience in interdisciplinary team-based care at multiple award winning hospital sites located throughout San Diego County. Unique to this program is the diversity of learning experiences that will offer invaluable opportunities for professional development in areas including, but not limited to: infectious diseases, internal medicine, emergency medicine, critical care, transitions of care, neonatal intensive care, and nutritional and metabolic support. Additionally, elective learning experiences in trauma, oncology, and specialty pharmacy, among others, will be available for those interested in these specialized areas. Residents will also obtain a teaching certification, precept students, and be given the flexibility to personalize the residency experience to meet their career goals. AWARDS AND RECOGNITIONS 2019 • 100 Best Places to Work
    [Show full text]
  • New Employee Orientation Reference Materials
    New Employee Orientation Reference Materials 2020 SHARP AGENDA NEW EMPLOYEE ORIENTATION AGENDA MORNING 8:00 – 9:00 Welcome Onboarding paperwork 9:00 – 9:20 Introductions NEO Facilitators: Allyson Alexander, Katie Beardsley, Anita Caro, Justin Dorow, Denise Phan, Rachelle Rhodes, Ingrid Salazar, Lorraine Vargas, Kala Waddington 9:20 – 9:30 Organizational Overview History, Facilities & Organizational Structure 9:30 – 9:40 Mission, Vision, Values and Philosophy 9:40 – 10:45 Sharp Experience Pillars of Excellence, Five Must Haves, Behavioral Standards, AIDET, Principles and Performance Target Goals Video: Sharp Experience Documentary 10:45 – 10:55 Morning Break 10:55 – 11:35 Clinical Effectiveness and Quality Speaker: Samantha Crandall, Cheryl Dailey, Lisa Kelley, Alexandra Perreiter, Diana Schultz, Jeanine Wagner-Woods Patient Safety and Quality Improvement, Quality Vision, Goals and Aims, RL Solutions, Six Sigma 11:35 – 12:20 Benefits Speaker: Curtis Carter, Jennifer Corrington, Kathy Materiale, Renada Peters Benefit Coverage - Medical, Dental, Insurance, PTO, ESI, Employee Assistance, Intranet – Benefits, Sharp $aver Retirement Plan, Tax Deferred Annuity Program, Credit Union 12:20 – 1:00 Lunch & Employee Badges Sharp HealthCare New Employee Orientation The best place to work, best place to practice medicine, best place to receive care AFTERNOON 1:00 – 1:20 Infection Control Breaking the Chain, Hand Hygiene, Universal/Standard Precautions, TB- controlling the spread, Water and Bio-Hazardous Waste Disposal, Isolation Precautions 1:20 –
    [Show full text]
  • Sharp Healthcare the BEST PLACE to WORK, PRACTICE MEDICINE, and RECEIVE CARE
    Sharp HealthCare THE BEST PLACE TO WORK, PRACTICE MEDICINE, AND RECEIVE CARE 2007 MALCOLM BALDRIGE NATIONAL QUALITY AWARD APPLICATION HEALTH CARE CATEGORY 8695 Spectrum Center Blvd., San Diego, CA 92123 Confidential • May 24, 2007 Submission TABLE OF CONTENTS 2007 Eligibility Certification Form Organization Chart Signed 2007 Application Form Glossary of Terms and Abbreviations Organizational Profile ....................................................................................................... i Responses Addressing All Criteria Items Category 1: Leadership..............................................................................................1 Category 2: Strategic Planning...................................................................................6 Category 3: Focus on Patients, Other Customers, and Markets ..............................11 Category 4: Measurement, Analysis, and Knowledge Management ........................16 Category 5: Workforce Focus...................................................................................22 Category 6: Process Management...........................................................................26 Category 7: Results..................................................................................................32 GLOSSARY OF TERMS AND ABBREVIATIONS related to an accident or other trauma, or after surgery. Acute care is usually given in a hospital by specialized 82-Sharp personnel, using complex and sophisticated technical Customer service specialists available Monday
    [Show full text]
  • Employee Handbook Is Your Guide to Being a Sharp Team Member and Living the Sharp Experience Every Day
    compensation community comfort health care system employee benefits health support service exceeding expectations patient-centered care team community thank you best place to receive care storytelling san diego’s health care leader finance caring paid time off making a difference passion teamwork best place to work duration pillars of excellence leader clinical excellence recognition best place to work excellence reflections growth vision and values dedication explanation patient-centered care integrity performance evaluations performance evaluations support thank you integrity hospitals service vision and values quality compassion creating memorable experiences Sharp HealthCare acknowledge grattitude collaboration clinical excellence introduce healing community leader advanced technology innovation Employee HanFrontdbo Coverok duration grattitude malcolm baldrige holidays families caregiver health care system behavior standards journey AIDET leader vision and values team member transforming the health care experience explanation leader must haves vision and values best place to practice medicine employee assistance program best in the universe Produced by Sharp HealthCare Human Resources 2014 “The future is not someplace we are going to, but a place we are creating. The paths to it are not found, they are made.”—Jane Garvey Dear Team Member: Welcome to Sharp HealthCare! We are an organization filled with passionate, determined and ambitious people — all dedicated to transforming the health care experience for our patients and their families. It’s what we call The Sharp Experience. Our vision is to be the best place to work, practice medicine and receive care, and ultimately the best health care system in the universe. This employee handbook is your guide to being a Sharp team member and living The Sharp Experience every day.
    [Show full text]
  • Sharp Coronado Hospital and Healthcare Center Community Health Needs Assessment Fiscal Year 2013
    Sharp Coronado Hospital and Healthcare Center Community Health Needs Assessment Fiscal Year 2013 ~ Committed to Improving the Health and Well-being of the Community ~ Sharp Coronado Hospital and Healthcare Center Community Health Needs Assessment Fiscal Year 2013 Table of Contents Preface ............................................................................................................................ ii Section 1: Overview ........................................................................................................ 1 Section 2: Executive Summary ....................................................................................... 3 Section 3: Methodology ................................................................................................... 9 Section 4: Community Defined ...................................................................................... 29 Section 5: Findings ........................................................................................................ 38 Section 6: Conclusion .................................................................................................... 70 List of Appendices Appendix A: Sharp Coronado Hospital and Healthcare Center Programs and Services .................................................................................................................................... 105 Appendix B: An Overview of Sharp HealthCare .......................................................... 106 Appendix C: Community Needs Index Map of San Diego County
    [Show full text]
  • Calpers Performance Network Overview
    CalPERS Performance Network Overview Effective March 31, 2019 Performance Network Plan medical groups The Performance Network offers more choice for people A plan medical group (PMG) is a designated group living in the North County area of San Diego. In addition of doctors, hospitals, specialty care and urgent care to our regional partners, we offer affordable access to centers associated with a network. It is important to Sharp’s award-winning medical groups, all dedicated to keep in mind that referrals and prior authorizations do 1 meeting your health care needs. not transfer between PMGs. You have access to only one PMG at a time. Your PMG will be listed on the front of your member ID card.2 1,700+ Doctors Sharp Rees-Stealy Medical Group This PMG includes more than 500 primary care 13 Hospitals physicians and specialists. Admitting hospitals are Sharp HealthCare facilities and Rady Children’s Hospital. Sharp Rees-Stealy Medical Group 7 Medical Groups physicians serve: • Carmel Valley • Mt. Helix • Chula Vista • Murphy Canyon 40 Urgent Care Centers • Del Mar • Otay Ranch • Downtown San Diego • Point Loma • El Cajon • Rancho Bernardo 450+ Pharmacies • Frost Street / • San Carlos Frost Street North • San Diego • Genesee • Scripps Ranch 15 MinuteClinics® • La Mesa / • Sorrento Mesa La Mesa West • Mira Mesa Find a doctor Visit sharphealthplan.com/CalPERS and click “Find a doctor” to see if your current doctor is in one of the listed plan medical groups, or to find one that fits your needs. 1 The data shown here reflects the Performance Network as of March 31, 2019.
    [Show full text]
  • Sharp Healthcare's HRO Commitment
    Sharp HealthCare’s HRO Commitment Daniel L. Gross, DNSc, RN Executive Vice President Amy Adome, MD, MPH Senior Vice President, Clinical Effectiveness November 3, 2016 “ “Perfection is not attainable, but if we chase perfection, we can catch excellence.” – Vince Lombardi Sharp HealthCare • Grew from one hospital in 1955 to an integrated health care delivery system • Largest private employer in San Diego – 17,000 employees – 2,600 affiliated physicians – 3,000 volunteers Sharp HealthCare Not-for-profit serving 3.2 million residents of San Diego County • Two affiliated • Home Health • Centralized system medical groups support services • Hospice • Four acute care • Largest health care hospitals • Home infusion system in San Diego programs with highest market • Three specialty share hospitals • Fully integrated information • A health plan technology systems and infrastructure • Numerous outpatient and urgent care clinics Sharp Grossmont Hospital 4 Acute Sharp Memorial Hospital Care Hospitals Sharp Coronado Hospital and Healthcare Center Sharp Chula Vista Medical Center Sharp Mary Birch for Hospital for Women & Newborns 3 Specialty Hospitals Sharp Mesa Vista Hospital Sharp McDonald Center Sharp’s Vision and Structure for All that We Do Sharp will transform the health care experience through a culture of caring, quality, safety, service, innovation, and excellence and be recognized by employees, physicians, patients, volunteers, and the community as: The best place to work, The best place to practice medicine, and The best place to receive care. Sharp will be known as an excellent community citizen embodying an organization of people working together to do the right thing everyday to improve the health and well-being of those we serve.
    [Show full text]
  • Sharp Health Plan Premier Network Overview 2021
    Premier Network Overview The Premier Network offers access to award-winning Sharp HealthCare physicians and medical groups conveniently located in central San Diego County. With Premier, you will receive the most cost-effective premium rates and have access to more than 1,100 physicians.1 1,100+ Doctors Find a doctor Visit sharphealthplan.com/findadoctor 10 Hospitals to see if your current doctor is in the Premier Network, or to find one that fits your needs. 2 Plan medical groups 30+ Urgent care centers Consider us your personal health care assistant® 475+ Pharmacies If you have any questions, please contact Customer Care by email at ® [email protected] or MinuteClinic locations by phone at 1-800-359-2002 from nationwide 8 a.m. – 6 p.m., Monday through Friday. Plan medical groups Hospitals3 A plan medical group (PMG) is a designated Sharp hospitals group of doctors and hospitals associated with • Sharp Chula Vista Medical Center your network.2 You have access to hospitals, • Sharp Coronado Hospital and specialty care and urgent care centers affiliated Healthcare Center with your PMG. It is important to keep in mind that referrals and prior authorizations • Sharp Grossmont Hospital do not transfer between PMGs, and you have • Sharp Mary Birch Hospital for access to only one PMG at a time. You can visit Women & Newborns sharphealthplan.com/PMG to learn more. • Sharp Memorial Hospital • Sharp Rees-Stealy Medical Group Additional hospitals • Sharp Community Medical Group • Palomar Medical Center, Escondido • Palomar Medical Center, Poway Urgent care centers • Rady Children’s Hospital (2 locations) • Temecula Valley Hospital Visit sharphealthplan.com/urgentcare to search among the 30+ urgent care centers affiliated with the Premier Network.
    [Show full text]
  • Sharp Premier Provider Network Overview
    Sharp Premier Provider Network Overview Physicians • Hospitals • Urgent Care Centers • Pharmacies • Other Facilities Effective January 1, 2018 Sharp Premier Provider Network Medical Groups At Sharp Health Plan, we understand the importance of selecting a network that fits your lifestyle and budget. As a member, you’ll join a family of award-winning medical groups, physicians and hospitals dedicated to meeting your health care needs. The Sharp Premier Provider Network offers access to Sharp HealthCare physicians and medical groups conveniently located in central San Diego County.1 Sharp HealthCare is San Diego’s most comprehensive health care delivery system, recognized for clinical excellence. With Sharp Premier, you will receive the most cost-effective premium rates within the Sharp Health Plan portfolio and have access to more than 1,100 physicians, including Primary Care Physicians and specialists. Sharp Rees-Stealy (SRS) This medical group offers a network of more than 385 physicians, including Primary Care Physicians and specialists. Admitting hospitals include Sharp HealthCare facilities and Rady Children’s Hospital. SRS physicians are located throughout San Diego County, including: • Carmel Valley • La Mesa • Rancho Bernardo • Chula Vista • La Mesa West • San Carlos • Del Mar • Mira Mesa • San Diego • Downtown San Diego • Mt. Helix • Scripps Ranch • El Cajon • Murphy Canyon • Sorrento Mesa • Frost Street • Otay Ranch • Genesee • Point Loma Sharp Community Medical Group (SCMG)2 This medical group offers a network of more than 720 physicians, including Primary Care Physicians and specialists. Admitting hospitals include Sharp HealthCare facilities and Rady Children’s Hospital. SCMG physicians are located throughout San Diego County, including: • Alpine • El Cajon • National City • Chula Vista • Imperial Beach • Point Loma • Clairemont • Kearny Mesa • Santee • Coronado • La Mesa • Tierrasanta • Downtown San Diego • Lakeside • University City • East San Diego • Mira Mesa 1 Service area does not include all San Diego County ZIP codes.
    [Show full text]
  • Sharp Healthcare, Feedback
    September 10, 2015 Ms. Jennifer Kent Director California Dep artment of Health Care Services VIA Email RE : DHCS "CCS Redesign Whole Child Model" Proposa l Dear Ms. Kent: Sharp HealthCare (Sharp) is San Diego's largest private employer, largest provider of health care including care to the Medi-Cal population and operates three hospitals where women receive extraordinary maternity care. Two of these hospitals, Sharp Grossmont and Sharp Mary Birch also operate Neonatal Intensive Care Units, with Mary Birch the largest NICU in the region. These facilities and Sharp-affiliated physicians receive reimbursement for care to the CCS population. I understand that San Diego County will not be among the first to implement the CCS Redesign and that its current CCS structures will remain in place. While implementation in San Di ego is assumedly several years off and contingent upon lessons learned from other counties, it is important that the Department's CCS Redesign Whole-Child Model (CCS Redesign) be cl arified to ensure there are not unintended consequences for Sharp NICU s. The proposal as drafted is silent on the matter of NICUs, and we assume the intent is that they would be part of health plans' provider networks. We ask that this be cl arified with the additional explication that it is imperative that women be provided choice during this critical life event. Another consideration is the recently operationalized Rady Children's Hospital CCS ACO (Rady ACO) that the state has requested continue under the 1115 Waiver. While Sharp does not provide CCS care to children with the conditions covered by the Rady ACO, it is imperative that this ACO not be presumed to be the model for future care for an expanded population beginning at birth.
    [Show full text]
  • Sharp Health Plan
    Individual & Family Plans Rebecca Palazzo & Chris Simonds- August 25, 2020 Agenda • About Sharp Health Plan • Networks • COVID-19 strategies • CVS Pharmacy® • IFP team Sharp is an integrated Built on a foundation of common systems delivery system and organizational infrastructure Sharp Health Plan · Not-for-profit serving 3.2 million residents of San Diego County · Largest health care system in San Diego with highest market share · 3 decades of capitation experience Sharp Rees-Stealy Sharp Community Medical Group · Fully licensed health plan serving Medical Group the San Diego MSA for 25 years · 145,000 total covered lives Hospitals · Nationally recognized for quality and service · Below market-medical cost trend and administrative costs Quality & Physician Customer Population IT Leadership Financial Data /Claims Clinical Leadership Experience Health Alignment Effectiveness Management SharpSeptember Health 14,Plan 2020 | sharphealthplan.com Sharp Health Plan | Confidential – not for public distribution 3 Service leadership position in the market Sharp Health Plan: Highest member-rated health plan in California Highest member-rated in California among reporting California Health Plans Health Plan | Health Care | Personal Doctor | Specialist *Among reporting CA plans. Based on 2015, 2016, 2017, 2018 and 2019 NCQA Quality Compass CAHPS results. Quality Compass is a registered trademark of NCQA. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). SharpSeptember Health 14,Plan 2020 | sharphealthplan.com
    [Show full text]
  • Enrollment Guide Including Summary of Benefits
    2021 Sharp Direct Advantage® Medicare Enrollment Guide Including Summary of Benefits Sharp Direct Advantage Basic (HMO) and Sharp Direct Advantage Premium (HMO) Exclusively for Medicare-Eligible Former Sharp HealthCare Employees and Their Dependents Balboa Park Table of Contents The basics of Medicare 2 The Sharp Direct Advantage difference 3 Your care team 5 Your network 7 Your benefits 11 Added benefits 13 Your prescription drug benefits 15 Comprehensive Dental Coverage by Delta Dental 17 Best Health wellness program 19 Get the care you need, as soon as you need it 21 We’re just a click away 23 Understanding enrollment 25 2021 Summary of Benefits 29 Frequently asked questions 39 Language assistance services 41 Nondiscrimination notice 42 1 sharpmedicareadvantage.com/sharpretirees The basics of Medicare Have questions? We have answers! It’s common for people to be confused about Medicare and how they can benefit from it. Simply put, Medicare is a federal health insurance program available to you once you turn 65 or if you have certain disabilities. There are four parts to Medicare coverage. Part A – Hospital Insurance Once you turn 65 or otherwise become eligible for Medicare, you can automatically receive Medicare Part A hospital insurance. For most people, Part A has no cost. Part B – Medical Insurance Part B covers certain doctor services, other outpatient care, medical supplies and preventive services. Part B has a monthly premium. Together, Part A and Part B are known as Original Medicare. Part C – Medicare Advantage Medicare Advantage plans, also known as Part C plans, are offered through private insurers and combine Part A, Part B and often Part D into one plan with more benefits than Original Medicare.Sharp Health Plan offers a Medicare Advantage / Part C plan.
    [Show full text]