How the Women and Children’s Health Alliance is helping pediatricians thrive in a value-based world

Healthcare’s evolution toward value-based care could largely impact independent physicians. To keep his independence and help other physicians do the same, Gerard M. Cleary, DO, and his neonatology group, worked with local primary care and specialty pediatricians to create the Women and Children’s Health Alliance.

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The Women and Children’s Health Alliance is a clinically integrated network in Pennsylvania trying to revolutionize pediatric and obstetrical care for patients, providers and payers.

The alliance provides independent physicians an outlet to collaborate clinically and retain their independence, according to Dr. Steven Shapiro, vice president of clinical integration – primary care at the Women & Children’s Health Alliance.

“It’s a mechanism for independent practices to thrive in a value based medical economy,” Dr. Shapiro says.

The Pennsylvania Medical Society’s subsidiary, the Care Centered Collaborative, recently partnered with the Women and Children’s Health Alliance, positioning the alliance as the pediatric clinically integrated network for the entire state of Pennsylvania. In addition to the Care Centered Collaborative, Dr. Cleary has been working with his colleagues and the faculty at the Harvard TH Chan School of Public Health Master’s in Healthcare Management Program to refine concepts and modeling.

The physician-owned and led alliance serves as a resource to independent physicians by connecting them to each other through the network. The network shares best practice guidelines, clinical and claims data aggregation, and operational strategies among practices to refine guidelines and increase quality of care. At the alliance’s center is one goal, “to improve care in the community,” Dr. Cleary says.

By aligning these physicians, Dr. Cleary says the industry can improve quality and community access for pediatric patients.

The alliance can benefit independent physicians because physicians can reap analytical benefits like those of large health systems while maintaining their brand, staff, networks, EHRs and several other aspects. The alliance takes independent practices and moves them towards value-based care, without changing infrastructure.

Dr. Cleary focused on pediatrics after realizing a full spectrum clinically integrated network that included adult practitioners would not incorporate the intricacies of pediatric health, especially concerning reimbursement. Dr. Cleary says among the alliance’s goals is to work with payers to develop a better-suited pediatric reimbursement model. By leveraging shared clinical and outcome-based data, Dr. Cleary believes the alliance could shape reimbursement practices in a rapidly evolving post Medicare Access and CHIP Reauthorization Act of 2015 world.

Hospital-owned practices are not excluded from the alliance either. In fact, hospital owned and large groups practices are encouraged to join and leverage the pediatric specific data while networking with independent physicians.

To learn more about the Women & Children’s Health Alliance, click here.

To learn more about the Care Centered Collaborative, click here.

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