Wellvana requires a participation agreement where physicians agree to perform in ways that are required for the CIN to achieve clinical and financial integration. The physician Participation Agreements also call for physicians to actively engage in the business enterprise and to support its purposes.
Performance improvement initiatives.
Wellvana will seek to deliver value and each participating physician will be expected to adhere to all performance measures that are relevant to his or her specialty.
Attendance at educational, governance, or other program-sponsored meetings.
These sessions are designed to aid physicians in achieving quality goals or setting program strategy.
Participation in all jointly negotiated payer contracts.
Joint contracting is vital to ensure that patients can remain within Wellvana—enhancing care coordination and increasing data available for performance monitoring. If a physician enters into such an agreement, the Stark Law requires sustained participation for one year or more.
Performance monitoring processes.
Through monitoring, the program can identify physicians who may need assistance or support, determine how goals should be revised year over year, and prove program value to payers, employers, and patients.
Use of information technology (IT) systems.
A data warehouse supports physicians’ ability to manage and improve patient outcomes, and the network’s ability to monitor and improve performance overall.
Payment of organizational dues.
Physician contributions are a clear demonstration of commitment to program success and helps indicate that financial integration exists among the participating providers.