Health4/Clinical Integration
What is Health4
Health4 is our Clinically Integrated program. Health4 will ensure continuity of care in all settings by integrating a network comprised of approximately 1,600 MGO physicians and the OhioHealth facilities. Health4 will enhance MGO physicians’ ability to provide the highest quality of care to their patients by providing them with accurate and timely clinical information.
Negotiating with payers is necessary to implement the Health4 program. Currently, Health4 has clinically integrated contracts which include enhanced fee schedules, “Pay for Quality” programs and gain share opportunities with Medical Mutual of Ohio (MMO) and Aetna.
Quality is at the Core; and is Measurable
As health care evolves – it is becoming increasingly clear that providing proven value and delivering quality health care will be expected, as well as rewarded, and increasingly necessary for the ongoing success of physicians.
We are utilizing Valence Health’s physician support tool to effectively share meaningful data/information, actionable patient reports, and standardized quality metrics and guidelines. This state of the art tool is provided to all Health4 physicians.
Health4 has a proven track record of success and is the leading value delivery network in the Central Ohio health care market.
Frequently Asked Questions
Click here for the Frequently Asked Questions about the MGO/Health4 network.
Click
here for the Frequently Asked Questions about Actionable Reports.
PRIMARY CARE CONNECTION
Health4 is pleased to announce a Pay for Quality program which compensates specialists and urgent care physicians/groups.
PRIMARY CARE CONNECTION - Frequently Asked Questions
The Primary Care Connection program was created recognizing the importance of having a primary care relationship, the power of your recommendation, and that the time you spend in promoting their coordination of care should be compensated.
Bonus Designation Form
Bonuses for the 2010 Pay for Quality Program will be paid in April, June and August of 2011. Physicians can designate payment of the bonus to their practice by completing a Bonus Designation Form.
A Few Helpful Hints on Data Submission Forms - November 2010
A key to maximizing P4Q results is to help us ensure the completeness of the Actionable Report data. The Data Submission form, answers to frequently asked questions, and an educational webinar about how to use your Actionable Reports are available.
Enhance Patient Care, Maximize Bonus Potential - October 2010 Actionable Report Mailing
The final 2010 Actionable Reports will be mailed next week. The reports will include information about your Aetna, CIGNA and OhioHealthy patients. They allow MGO physicians to not only enhance the quality of patient care but also maximize the potential bonus earned.
Sample Actionable Report
An example of the actionable report physicians received. Each physician received an individualized report with their real patient names shown.
Standards for Earning Rewards
2010 clinical measures and targets.
Frequently Asked Questions
Answers to the most commonly asked questions about MGO's pay for quality program.
Data Submission Form
Use this form to provide additional clinical information that may not have been provided in claims files, for example if a patient had a had a colonoscopy more than three years ago.