Grand View Healthcare Partnership For Providers

What is Grand View Healthcare Partnership (GVHP)?

GVHP is an Integrated Delivery Network (IDN), comprised of physicians and other healthcare providers, formed to develop clinical initiatives focused on insuring quality, performance, efficiency and value for our community healthcare needs.

GVHP is a formal network under a parent holding company that provides coordinated healthcare services to patients in a particular geographical region.

What’s driving the movement toward clinical integration and IDNs?

In the coming years, physicians and hospitals must partner more closely than ever before to ensure that the community receives the highest quality and value for their healthcare dollars.

As we move from today’s fee-for-service reimbursement models to new performance and value-based pay models, IDNs enable healthcare providers to join together to enhance the health of a community. These networks bring value to patients, payers and physicians by improving transitions of care, coordinating chronic disease management, and managing the health of a population.

What does an IDN do?

An IDN helps physicians align with a hospital to coordinate care across the continuum, focusing on quality and performance and preparing for new incentive-based compensation programs.

What is the purpose of the IDN?

The purpose or goal is to enhance the efficiency of patient care services provided by participating healthcare providers. The clinical performance standards and protocols will form the basis for the network to negotiate contracts with payers for performance incentive programs.

How is the IDN structured?

The IDN will be a wholly owned subsidiary of Grand View Health, under its own tax ID, managed by a newly established board of directors. Physicians who are willing to participate in a meaningful way have the opportunity to be involved in the organizational committees that will drive the network. GVHP will be driven by the PCPs, but will include specialists.

What are the benefits of joining GVHP?

For physicians, the network offers the opportunity to:

• Become available as a preferred network provider to members.
• Use care coordination resources provided by the IDN.
• Reduce duplication of patient services.
• Identify and measure best practices.
• Improve outcomes for patients.
• Receive financial rewards for value-based outcomes and achievements.

The objective of GVHP is to provide an exemplary patient experience and improve the health of individuals in our community. This approach serves as the platform that will determine financial incentives for physicians.

What is the difference between an IDN and an Accountable Care Organization (ACO)?

• An ACO is an IDN specifically developed to meet the Centers for Medicare and Medicaid Services (CMS) contracting criteria for caring for patients through the Medicare Shared Savings Program (MSSP).
• According to the CMS, an ACO is accountable specifically for Medicare beneficiaries. It is an organization of healthcare providers that agrees to be accountable for the quality, cost and overall care of Medicare beneficiaries enrolled in the traditional fee-for-service program who are assigned to the ACO.
• Similarly, an IDN is an alignment model, coordinating care across affiliated caregivers and developing contracts with payers including value-based contracting initiatives with commercial payers and Medicare.

Can my practice participate in Tandigm Health or other ACOs and GVHP?

• Tandigm is an Independence Blue Cross product for Medicare Advantage and Keystone patients.
• We believe the answer is yes; however, it is important for you to review your contracts before enrolling in GVHP.