When it comes to the physicians she represents, Cara Farrell isn't afraid to fight for what she thinks they deserve.
In her five years as director of managed-care contracting for Women's Health Connecticut, Farrell has secured annual fee increases of 4% to 16%,
generating almost $20 million in additional revenue for the group practice's 150 OB/GYNs. She also developed a pay-for-performance program to improve quality of patient care and lower healthcare costs and led a liability surcharge initiative to address the rising costs of medical malpractice coverage.
"She's been an incredibly professional representative and voice of the specialty," says Nancy Bernstein, president and chief executive officer of Women's Health, an Avon, Conn.-based joint-venture management-services organization.
"We are considered a model in OB/GYN in the U.S., and she's participated in every element of this company's reputation." The success of the Connecticut model sparked plans for a second practice-management partnership in New York that so far has attracted about 80 physicians.
Farrell traces her interest in healthcare to childhood. When she was 6, her father suffered a mild heart attack, and she was inspired by his physician's ability to reassure her and explain the situation on a child's level. She considered a career in cardiology but also had an interest in business.
After earning a master's degree in public health from Yale University in 1990, she honed her analytic and project-management skills as a healthcare information consultant to employer and health plan customers.
Her role at Women's Health, she says, "has been really rewarding because you can have a much greater impact on the quality of care and delivery of healthcare."
Thanks to the pay-for-performance program Farrell designed and implemented last year, Women's Health OB/GYNs have improved rates of cervical cancer screening and postpartum visits and are following guidelines from the American College of Obstetricians and Gynecologists to offer women less-invasive alternatives to hysterectomy, such as ablation. Of patients who are candidates for hysterectomy, about 45% now are treated with an ablation, compared with about 19% in 2000, Farrell says. "This translates to thousands of patients for whom hysterectomies were avoided and who were able to resume normal activity levels within days rather than weeks," she says.
This year, the program added a measure to improve postpartum-depression screening and treatment.In 2004, Farrell led an initiative to raise the fees of Women's Health OB/GYNs to cover mounting professional liability premiums without passing those costs on to patients. Farrell persuaded major health plans to shoulder the costs of the fee increases.