Wellstar Clinical Partners (WCP) is the name for Wellstar’s clinically integrated network.
A. WCP’s Vision and Mission are as follows:
• Vision: To deliver world-class healthcare to every patient, every time.
• Mission: To enhance the health and well-being of every person we serve.
• Values: To serve with compassion, pursue excellence and honor every voice.
A. Clinical integration is a structured collaboration between community and employed clinicians and health systems to develop active and ongoing clinical initiatives designed to improve the quality and efficiency of healthcare services.
A. An effective clinically integrated network (CIN) adopts initiatives that involve all clinicians committed to a common set of clinical quality goals. These goals are likely to improve the health of a community and provide measurable results in quality improvements, efficiency of care and patient safety. Measurable results can also be used to compare clinician performance, which results in quality improvement.
A. Clinical integration involves both private practice clinicians and employed clinicians, who join together in an organization or network that allows them to:
1. Identify and adopt best practices for the treatment of patients.
2. Develop systems to monitor performance against adopted metrics.
3. Collaborate with facilities to improve continuum of care.
4. Enter contractual arrangements with health plans that recognize clinicians’ efforts to improve quality and efficiency.
A. Physicians and advanced practice providers (APPs) have numerous and overlapping motivations for joining together in clinically integrated networks including the following:
1. Enhancing the quality of care provided to patients.
2. Allowing clinicians and health systems to market themselves based on higher quality.
3. Collectively negotiating with payors as a network with quality and best practice as the focus.
4. Access to technological and quality improvement infrastructure that enables evaluation of clinician performance.
A. Partnering with a health system will provide advantages to a network of private practice clinicians in the development of clinical integration. When the health system shares the same quality vision as the clinicians, as it does here, the health system can be a powerful ally in program development by:
1. Developing clinically integrated initiatives using existing inpatient quality measures.
2. Providing operational infrastructure and personnel in support of the organization.
A. Yes. Wellstar and the Independent Physicians Organization (IPA), under the direction of highly engaged community physicians and Wellstar senior leaders, formed a steering committee made up of affiliated and employed physicians tasked with the development of WCP. That committee-chartered taskforce focuses on distinct areas related to quality metrics, population health, operating models and informatics. In total, approximately 50 physicians contributed to the WCP development process.
A. WCP is a physician-led and physician-driven organization. WCP is managed by a Board of Managers which consists of 15 – 20 voting members. Four functional committees support the implementation of WCP’s Strategic Plan and provide operational oversight for WCP’s clinical integration programs and initiatives. These committees are Finance & Contracting; Provider Network; Strategy, Governance and Ethics; and Quality, Population Health and Informatics.
A. WCP has reorganized its governance structure to integrate our newest regions into the WCP network. This new structure consists of eight local chapters organized by geography and aligned with the Wellstar hospitals in those regions.
A. WCP is a vehicle for all clinicians within the community to develop and fine-tune best practice methods. Enhanced coordination of care will improve all aspects of population health management.
A. There are benefits for everyone—not just the System. Patients will receive better value of health care. Clinicians will improve quality and be rewarded for successes. Payors will want to partner with us as a clinically integrated network because of aligned incentives.
A. WCP continues to negotiate with payors and/or employers for demonstrated improvement of quality metrics. These include performance incentives and/or shared savings and will likely be in addition to the practice’s existing contracted fee-for-service rate.
A. The contracting committee is comprised of WCP board members, physician members and advisors working in conjunction with the Wellstar Health System managed care team. Negotiations will proceed under guidance of a contracting policy with the intent to provide economic benefit for WCP physicians. All contracts will require the approval of the WCP Board.
Participation
A. Generally, the entire group and all physicians must sign up together. However, in certain situations, practices with offices outside of the WCP service area may be granted an exemption to this requirement by the WCP Board.
A. WCP has approximately 4,300 employed and affiliated members. Effective January 1st, 2025, advanced practice professionals also become eligible for membership in WCP.
A. No. Referrals within the WCP network are not required but are encouraged as it is beneficial to facilitate improved care coordination.
A. No. You may enroll in WCP at any time.
A. WCP has developed guidelines for branding and signage that allow WCP members to display both the independent organization and WCP logos on business cards, outdoor signage, and doors, but Wellstar must review and approve any use or materials containing the Wellstar logo.
A. Each group provider is generally required to maintain privileges at a Wellstar-affiliated hospital; however, the WCP board may waive this requirement at its discretion. All providers are required to be credentialed with payors.
A. No, WCP will contract on behalf of physician offices for professional services, not facility services.
A. The PPA can be emailed as a PDF, and a copy will be mailed to the mailing address provided.
A. As a member of WCP, you will report on quality data for all patients and payors within your practice and participate in quality initiatives.
A. The quality metrics for WCP are vetted each year and selected by a quality task force utilizing input from physician advisors representing each specialty. A quality coordinator will schedule a meeting with you to help you select your practice focused measures.
A. WCP will collect quality data on patient encounters as applicable to diagnoses, procedure codes, CPT II quality codes, and other relevant information to the quality program.
A. Access to data is restricted to specific individuals and for specific purposes as approved by the WCP Board, including monitoring quality metrics performance, adherence to care protocols, coordination of care and other activities in support of clinical integration objectives. All usage of data will be subject to review by the WCP Board of Managers and audited by an independent firm to ensure compliance with Wellstar and WCP policies.
A. WCP Quality, Population Health and Informatics Committee, as well as the WCP quality team, will monitor the quality program and each physician’s performance.
A. Data not related to the clinical integration program will be removed and saved in a secure location, not available for reporting or analysis by any individual. The security of this data is protected by WCP policies and will be audited regularly by an independent firm to ensure compliance.
A. Ultimately, quality will be tracked and reported at least quarterly, or more often as required by regulatory requirements or payor contracts.
A. Once implemented, the scorecard will be available for clinician review monthly.
A. Yes. WCP has quality coordinators who serve as global resources to the quality program and assist all WCP practices with action planning for performance improvement of quality metrics and the sharing of best practices. Feel free to reach out to [email protected] if you need additional assistance.
A. To participate, practices will be required to report practice-based quality metrics by CPT II codes collected through the electronic billing system. There are also additional requirements for the use of a Certified Electronic Health Record Technology (CEHRT) that meets the Office of the National Coordinator for Health Information Technology (ONC).
A. The collection of quality metrics may require some revisions to practice workflows; typically, this can be accomplished with your practice’s existing staff.
A. Yes. WCP will have resources available to work with office managers regarding metric definitions and specifications.
A. At this time. WCP will not be able to collect data from specialty registries. Therefore, WCP intends to collect this data via claims submission from clearinghouses utilized by the practices or via clinical connectors to Arcadia.
A. The quality metrics for WCP were vetted and selected by a quality taskforce utilizing input from physician advisors with representatives from most specialties. The quality committee will address any specialty-specific concerns for your practice.
A. Yes.
A. To join the ACO you will need to sign a separate ACO contract. The ACO and WCP agreements are separate and independent.
If you have additional questions regarding WCP, please contact [email protected] or call 470-644-0889.
