Why did the founding providers create Centrus Health?
• To strengthen alignment and engagement with employed and independent physicians to deliver value-based care and support other initiatives;
• To demonstrate superior quality to current and future patients;
• To respond to emerging market pressure in Kansas City and across Kansas from payers, employers and patients for higher value care (higher quality at lower costs), narrower networks, and new payment models (e.g., fee-for-service to value-based);
• To share the investment cost of establishing a population health infrastructure, technology and analytics through economies of scale;
• To drive consumers to high-value providers.
What are the benefits of participating in a Clinically Integrated Network?
• Timely access to patient quality data for decision-making and an explanation of the total costs of patient care across all providers participating within the region;
• Access to staffing and technology resources to help improve quality and efficiency of care;
• Support to improve performance under government mandated (e.g., MACRA/MIPS) or voluntary programs (e.g., CPC+ or the Medicare Shared Savings Program);
• Collectively negotiate value-based contracts as a larger, integrated entity with commercial health plans and self-funded employers;
• The ability to thrive in value-based reimbursement models.
What do I need to do and how much time will this require?
• Centrus Health providers will collaborate to develop and share best practices, with a goal of advancing quality and outcomes and coordinating care for patients within the network. To enable individual and network-wide performance analytics, your practice will share clinical and demographic data with Centrus Health. The amount of time required will depend on your level of involvement in leadership and governance, which is at your discretion.
Some physicians are already participating in a physician-led development process. In the future, there will be a variety of committees that are open for physician participation.
How does participation in Centrus Health differ for primary care physicians and specialists?
• Initially, Centrus Health will focus on collaboration with primary care physicians. Current contract opportunities are centered on primary care measures, creating a business case for their involvement and laying a strong foundation for value-based care. Beyond the initial network development, as the business case opportunity for specialists develops, we will engage ambulatory medical and acute care specialists to more actively contribute in Centrus Health.
How will participation impact my day-to-day practice operations?
• Being an active participant in a CIN requires effort to improve quality, improve efficiency, and decrease cost. Centrus Health’s goal is for these efforts to have minimal impact on daily practice operations, however, some alteration in practice workflows and clinical documentation may be required initially as population health software is implemented within your practice. In order to improve the quality and efficiency of care delivery within the network and achieve the network’s agreed upon goals, your practice may need to transform in the following ways:
— Clinical documentation (e.g., documenting specific quality measure components in discrete data fields, limiting utilization of free text documentation, etc.)
— EHR optimization (e.g., creation of dot or smart phrases to simplify documentation, standardization of documentation practice, improving the ease of referral processing, etc.)
— Quality measure analysis and reporting – For practices that already track and report quality measures, efforts will be made to align programs and avoid duplication of efforts, however, processes will need to be developed for interfacing with CIN software, sending and sharing data securely, etc.
— Practice transformation activities (e.g., modifying support staff roles and responsibilities to ensure top of license work, organizing healthcare teams and meeting regularly to plan patient visits and review quality data, optimizing provider-patient time in a visit to fully allow preventative and acute care issues to be addressed)
Centrus Health commits to actively supporting the participating practices and physicians throughout the process of change and implementation.
If I’m unable to meet Centrus Health’s quality standards, what resources will be available to help me improve?
• The overall objective of Centrus Health is to improve patient outcomes and the quality of care delivered in our communities. In order to fulfill this objective, there is a Quality Performance Improvement Policy that establishes the process for monitoring and evaluating ongoing clinical performance of participants. This process will provide support, mentoring, and implementation of performance improvement action to physicians as needed. Additionally, there will be other staff resources to identify and address barriers to achieving benchmarks on quality measures. While rare, providers that are unable to meet Centrus Health’s quality standards after an opportunity to improve would be removed from the network and lose access to the Centrus Health value-based contracts and resources.
How will my current reimbursement and/or compensation be affected?
• Centrus Health will not be involved in practice compensation or fee-for-service arrangements. Decisions and negotiations regarding these will remain with each practice and employer. As allowed under Federal Trade Commission guidance, Centrus Health will collectively negotiate value-based contracts designed to bring in additional financial opportunities for its participants.