Before developing this important initiative, we listened carefully to the interests and concerns of the employers who purchase health care, the insurers who finance it, and the working men and women and their families throughout the Territory who us it. You told us that you wanted an approach to health care delivery that offered a wide choice of physicians, facilitated ease of access and administration, supported the need for an appropriate balance between cost and quality of care, and increased financial predictability.

With those directions in mind, the area's most experienced health professionals designed and are implementing a  Preferred Provider Organization (PPO). It's called V.I. Equicare, and after you know more about it, you'll recognize it as an essential component in the kind of partnership needed to sustain an effective and affordable health care delivery system within the United States Virgin Islands.

Much of what the public reads, hears or experiences regarding managed care leads to a growing frustration over existing programs and future directions. In most cases, the frustration is focused on concerns about diminishing choice. Through our exceptionally comprehensive network of primary care and specialty physicians, health plan enrollees are sure to find a doctor whose practice style, training, and location, are compatible. This broad choice of physicians and the services they provide are determining factors in keeping employees satisfied with employer health plans. For insurers, this large panel, supports the ability to deliver varying plan designs, benefits. packages, and new products.

Along with fears about reduced choice, another persistent. concern is that managed health care will create a loss of local control. The negative image is usually one of unknown utilization nurses making treatment decisions in distant mainland cities. As an effective counter to this image, V.I. Equicare is
sponsored by a network of local, familiar physicians who put a familiar face on managed care. In addition the PPO is administered by people here in our community who have made a lifetime of specializing in the health care needs of the Territory.

V.I. Equicare was formed meet the current and future local market realities, not theoretical constructs regarding managed care. As a results it's positioned to succeed on the basis of effective management and financial commitment. Equally important the PPO is founded on the understanding that accessible, affordable, on-island health care will be available only when purchasers. payers, and providers take a partnership approach to building a viable health care delivery system. As part of their contract with the PPO, V.I. Equicare physicians provide an even more accountable resource because members monitor and discipline peers whose practice patterns are unacceptable on cost, utilization, or quality grounds.

The best health care in the world is of little use if people can't afford it. On the other hand, low-cost health care is not a good value if it's accompanied by low quality. To help bring balance to this basic equation, V.I. Equicare has operationalized medical management and utilization review procedures that help assure that plan members receive the right level of care at the right time and at the right place. At the same time, a strong emphasis on quality protocols helps maintain exceptionally high levels of care.

The most effective care, from both the standpoints of cost and individual health status, is preventive. In an effort to support the philosophy as well as the specific wellness behaviors that may be part of the benefits and financial incentives in carious plan designs, the physicians of V.I. Equicare offer a comprehensive range of preventive services. These clinical and informational services range from health screenings, well-child care, and immunizations to mammography health assessments, and a commitment to in-office health education.

The old saying about never getting a second chance to make a first impression takes on new meaning within the context of managed care penetration into the U.S.V.I. Residents are already conditioned through media coverage and misinformation to equate managed health care only with the sometimes restrictive and inflexible policies of HMO's. As a Preferred Provider Organization committed to choice, V.I. Equicare is determined to facilitate the learning process that will help employees and all consumers view managed health care as the best means of bringing together the highest level of care for the most reasonable cost