Advantages & How You Benefit | One Health Quality Alliance | Maryland

Advantages of the One Health Quality Alliance

One Health Quality Alliance is a clinically integrated network formed between Adventist HealthCare and area providers. Through this collaboration, One Health Quality Alliance aims to improve the health of patient populations and communities, while enhancing the patient experience and reducing the costs of health care.

How You Benefit

  • Payor Contracting and Exclusivity - One Health negotiates payor contracts on your behalf. Providers have the option to opt out. Practices can participate also in Medicare savings outside of One Health.
  • Low Fees - One Health offers a minimal annual participation fee for infrastructure support.
  • Billing Structure - Practices maintain and continue to use own Tax ID number and current billing
    arrangements.
  • Revenue Stream - Practices retain control over their own revenue stream and contracting.
  • Electronic Health Record - Practices retain their own EMR systems. One Health will establish a data feed for information sharing and analysis toward helping practices enhance performance.
  • IT Support - Practices receive support for data reporting and risk stratification.
  • Practice Management and Decision-Making - Practices maintain own identity, operational structure and staffing structure. Practice management and decision-making remains internal.
  • Group Benefits - Practices that participate in One Health Quality Alliance can:
    • Align with other like-minded physicians
    • Set the standard in regional healthcare
    • Access chronic disease management and care management of patients
    • Leverage financial and technical assistance
    • Participate in value-based contracts with insurers
  • Notification Period for Ending Participation - Participating practices can exit the network with four months’ notice.

FAQ

Below are some of the most common questions we receive about One Health. Still need additional information, please don’t hesitate to contact us directly.

What is the One Health Quality Alliance?

The One Health Quality Alliance is a physician-led, clinically integrated network designed to help providers enhance the quality of healthcare and lower total costs for the Washington, D.C. region.

One Health, managed by Adventist HealthCare, is an innovative health care delivery network where participants can benefit from the value created by the alliance.

What is a clinically integrated network?

A clinically integrated network (CIN) is a collaborative arrangement among healthcare providers who, while remaining independent entities, strive to improve health care quality, efficiency and costs. As a separate legal entity, the CIN can enter joint contracts with insurers toward delivering high quality, cost-efficient coordinated care.

What are the benefits of joining the One Health clinically integrated network?

Practices that participate in One Health benefit in many ways, including opportunities to:

  • Align with other like-minded physicians to set high standards of care and achieve clinical outcomes and cost containment;
  • Work together with other knowledgeable health care providers as the Maryland health care system transitions to a valuebased payment system; and
  • Set the standard in regional health care by serving in Clinical and Governance leadership roles in One Health

In addition, practices receive expert support to assist them with:

  • Chronic disease management and care management of its patients
  • IT infrastructure and patient registry builds

What does participation require of my practice?

Participation in One Health requires a commitment to implementing and achieving high performance together, as stipulated by the network’s negotiated contracts. One Health participant with are also accountable for both developing and complying with clinical initiatives. This involves having an IT system that can track and report quality, cost and utilization within the network.

There is also a membership fee/participating provider that will support the network infrastructure.

How will my practice get paid by commercial payors as a member of One Health?

While the network may negotiate under different payment models over time (fee-forservice, performance-based, risk), the details of how payments are made to each practice are explained on a contract-by-contract basis.

Practices always know the details of a contract BEFORE agreeing to participate and BEFORE negotiations commence.

What are the advantages of joining a health-system sponsored network over an investor or physician-owned network?

Partnering with a health system provides distinct advantages in developing true
clinical integration. Adventist HealthCare, the first and largest health system based in Montgomery County, Md., shares the same quality vision as our physicians, so that the network is uniquely positioned to:

  • Develop clinical integration initiatives using existing inpatient quality measures;
  • Provide financial assistance and personnel in the implementation of inpatient and outpatient initiatives that provide benefit to the community and are not tied to referral volume; and
  • Demonstrate the legitimacy and value of clinical integration.

How can I learn more about joining the One Health clinically integrated network?

Practices are encouraged to schedule a face-to-face meeting to receive additional information, learn more and ask questions by contacting:

Barbara Courtney, Associate Vice President,
Clinical Integration at 240-826-6178 or BCourtne@AdventistHealthCare.com </a href>

Mindi Cohen, MD, Medical Director,
at MCohen4@AdventistHealthCare.com

How Can We Help You?

Contact us to learn more about how the One Health Quality Alliance can help you and your practice.

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