Provider Insider

Services and Information

Winter 2020 | Issue No. 8

Services provided to Coordinated Care members.

 

Your membership in Coordinated Care offers you access to competitive, value-based contracts. Did you know it also includes a number of other services managed by a centrally located team? A comprehensive list follows; for more information about any of these services, please contact Paul Staley or Austin Bailey.

 

Finance:

  • Manage the incoming and outgoing distribution of payments to physicians.
  • Reconcile the attribution files from payers.
  • Produce modeling and financial analysis for various payment methodologies and contracts.
  • Budgeting and oversite of CIN expenses.

 

Payor contracting:

  • Negotiate value-based contracts.
  • Provide network rosters to payers.
  • Monitor contract performance with finance.
  • Monitor payer rosters, for narrow network alignment.

 

IT support:

  • Population Health modules utilized in Epic.
  • Provide Epic dashboards for contract and clinical activity performance.
  • Integrate CORHIO clinical data for CIN attributed lives.
  • Training on Epic tools and resources.
  • Cost and utilization dashboards.

 

Network engagement, marketing and communications:

  • Monthly performance and payer feedback communication.
  • Analyze data and provide site-specific feedback.
  • Education and printed materials for physicians and staff on value-based contracts.
  • Education on best practices for physicians and staff.
  • Patient education on value-based topics.
  • Monthly newsletters to physicians and staff.

 

Data analytics:

  • Gaps in care reporting.
  • Performance reporting.
  • Practice performance trending and comparisons with other CIN participants.
  • Physician roster and attribution reconciliation.

 

Centralized care team:

  • Complex care management.
  • Care management and care coordination workflows and best practices.
  • Post-acute care monitoring.
  • Transitions of care.
  • High- and medium-risk follow up.
  • Gap closure support.
  • Training for physicians and staff.

 

Pharmacy:

  • Pharmacy gaps assistance.
  • Monitor high-cost drugs by practice.
  • Education of pharmacy impact.
  • Developed Epic tools to identify patients in need of pharmacy intervention, document, and aggregate clinical pharmacy interventions for position justification.
  • Medication education and comprehensive medication review of patients.
  • Generic usage trending by practice.
  • Brand formulary compliance.