Community Care Physician Network
A Clinically Integrated Network for Bringing
Value and Quality to Healthcare Delivery
In North Carolina, healthcare reform is now a reality, though the component parts are still taking shape. One thing, however, is already clear: Payment reform is to be a key ingredient.
New payment models are set to bring big changes in how physicians and hospitals are compensated, with a focus on value over volume.
So can an independent practice survive in this changing environment? Absolutely, if practices plan accordingly.
The North Carolina Academy of Family Physicians (NCAFP), the N.C. Community Health Center Association (NCCHCA), and the N.C. Pediatric Society (NCPEDS) together convened a group of physician leaders to address the question, and to detail what best practices are needed for success in this new environment.
These leaders asked our state partners at Community Care of North Carolina (CCNC) to provide a vehicle through which independent practices can work together to demonstrate the quality of care they deliver, and to create efficiencies in their operations.
Enter the Community Care Physician Network (CCPN), a clinically-integrated network (CIN) and nonprofit LLC. A physician-led collaboration for independent physicians and other providers, CCPN is aimed at improving the quality of healthcare through the preservation of the medical home, preparation for health reform and value-based care, and using a proven population-management infrastructure by:
- Determining what support and services are needed to remain independent and demonstrate the value of services provided to our patient population
- Creating a vehicle able to partner and contract in the Medicaid-reform effort with Provider Led Entities (PLEs) and Managed Care Organizations (MCOs)
- Working collaboratively with specialists and hospitals to improve the quality and efficiency of patient car
- Leading in high-quality, cost-efficient care through population-health management to improve patient care, decrease costs, and demonstrate value
- Preserving the medical home model through CCNC’s proven medical home concept and infrastructure
- Enhancing relationships and partnerships with community organizations serving our patient populations
- Leveraging CCNC’s existing population-health-management infrastructure for more efficient and cost-effective care.
Advantages to Joining
Through CCPN, independent practices can collect quality and cost data that demonstrates value to payers – both public and private. Initially, CCPN will offer infrastructure in population-health management, provided by CCNC:
- Quality data collection and reporting
- Care and disease management
- Transitional support — across providers and delivery settings
- Comprehensive medication management
- Population stratification
- Behavioral health integration
Other centralized services and supports that may be identified by physician-members:
- Group purchasing
- Back-office support, such as coding and billing
- Patient Centered Medical Home (PCMH) certification
- A 24/7 Nurse Advice Line
- Health Information Exchange (HIE) connectivity
Fee for Joining
There is a two-tiered fee structure for joining:
- For physicians in practices with fewer than 15 physicians: a one-time enrollment fee of $75 per physician
- For physicians in practices or Independent Practice Associations (IPAs) with more than 15 physicians: a one-time enrollment fee of $50 per physician
CCPN is to be governed by a board composed primarily of participating physicians who will lead and participate in subcommittees that develop CCPN clinical improvement initiatives. Not all participating providers will desire, or be expected, to serve on the board or in various committees. However, providers that do participate will be able to ensure that CCPN operates in the best interest of all providers and patients.
Practices will be able to consider participating in contracts with payers, hospitals, employers, and other healthcare entities, as well as in community collaborations. As contracts are negotiated and presented to the CCPN members, however, individual physicians can opt-out of each opportunity.
CCPN is a non-exclusive model that can coexist with other initiatives and networks and will look for opportunities to partner with programs aligned with our quality and cost-effectiveness goals.
Note that CINs are not the same as Accountable Care Organizations (ACOs) that have Medicare Shared Savings Programs (MSSP), and that participation in a MSSP does not preclude your participation in a CIN.
For More Information
Consult a detailed FAQ for answers to questions you may have.
You may also contact Dr. Lawrence Cutchin, MD, FACP, Medical Director for CCPEC, at (919) 244-9549, or email@example.com.