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Letter from CEO/CMO

Dear Colleagues,

It was great to interact with many of you during our SPN Annual Dinner held on May 8th.  We had a wonderful evening where our PCPs and Specialists got a chance to network with each other and our guests including, Dr. J. Stephen Jones, newly appointed CEO of Inova, Dr. Amy Nguyen Howell, CMO for America’s Physician Groups, and Dr. Sunil Budhrani, CMO/CMIO for Innovation Health.

It gives me great pleasure to announce that Signature Partners has earned a shared savings of approximately $1.3 million for 2017 (we are in the process of finalizing the exact earned amount). This payment is based on a total cost of care for our attributed patient population that decreased by 3.5% for 2017, compared to the “market trend” (non-Signature Partners) that went up by 3.3%.

Translated, this means we outperformed other non-Signature providers by 6.8%, which is phenomenal and a direct result of all of your hard work!! Thank you all for helping SPN achieve these great results! We are working with the Innovation Health team to calculate the bonus amounts for the individual providers, and hope to distribute those next month. Based on our board-approved shared savings allocation model for 2017, gain share payments will be made to the practices with 20 or more attributed Innovation Health members, and are based entirely on attribution, with no variance based on the quality metric performance.

For the 2018 performance year (distributions to be made in 2019), quality performance will be factored in as well, which means in order to be eligible for 100% of our shared savings we will have to meet targets for eight quality metrics as a network and as a practice. Measurements of the metrics will be aggregated at the POD level, so all providers with a POD will achieve the same quality score. These quality metrics, along with the various cost savings opportunities, are reviewed during the POD meetings with the practice leaders, which are held quarterly. I strongly encourage a physician leader from your practice to join these meetings to learn all about our payor programs, quality metrics/targets, cost and utilization trends, and to meet your peers to learn best practices for performance improvement.

What can you do to maximize your bonus in 2018?

  1. Make sure you attend SPN POD meetings to review your quality, utilization and “gap reports” on a quarterly basis.
  2. Refer high risk patients to our care management program.
  3. If not on an EMR, or unhappy with you current EMR, contact Signature Partners to discuss implementing AthenaOne.
  4. Maximize our gain share amount by keeping total cost of care down:
    1. Educate your patients to avoid the ER except for true emergencies
    2. Provide same-day access for patients with urgent matters
    3. For any patient that is hospitalized, follow-up with them in your office within 2 – 5 days of discharge
    4. Prescribe lower cost generic medications when possible
    5. Avoid unnecessary testing, imaging and specialty referrals

Thank you again for your participation in Signature Partners, and congratulations for earning this payment for 2017. We look forward to working with you to more successes like this.

Sincerely,

Matthew Poffenroth, MD, MBA

CEO/CMO, Signature Partners

Letter from CEO/CMO

Dear Colleagues,

It is hard to believe that first quarter of 2018 is almost about to end, but this also means that very soon it will be time to distribute 2017 gain-share payments. Signature Partners expects to receive the final reconciliation numbers for our 2017 gain-share distribution from Innovation Health by the end of April. As of the end of the 3rd quarter of 2017, our cost and utilization metrics had a favorable trend compared to non-Signature Partners performance and hence we are expecting a sizeable gain-share distribution for 2017. Similar to last year, any gain share revenue will then be allocated out to the practices based on your proportional attribution of fully insured (non-exchange, non-self insured) Innovation Health members. Please note that for 2018 gain-share distribution, the Signature Partners Board has approved a change in how we allocate practice bonuses. As we will be held accountable as a network for our Innovation Health quality metrics, we will need to include the practice performance on quality metrics as part of the gain share allocation. As such, the individual practice allocation will be based partly on the attribution and partly on the performance on quality metrics.

As you are aware, we now have several other value-based contracts in place, including our contract with Johns Hopkins Health Care for USFHP (TriCare Prime) that went into effect in 2017, and a new Innovation Health Medicare Advantage program, which was launched in January 2018. We are also negotiating ACO contracts with a couple other commercial insurance carriers. Combining all these together, there is significant potential for value-based incentives for our providers as we continue to grow and work together to improve the cost and quality of health care for our patients.

One of the initiatives that we have started this year to improve our network performance, which is heavily dependent on provider engagement, is quarterly meeting of our network providers. All the primary care practices have been grouped into eight groups that have started meeting already.  This provides an opportunity for the providers in our network to come together and review our performance on quality and utilization metrics and share strategies to improve the performance. Our goal is to become the highest quality, lowest cost Network of providers in Northern Virginia. We believe that working together will benefit all of our physicians individually and as a network as we learn from each other how to engage our patients in quality improvement and utilization reduction. Please be on the lookout for an invitation coming your way to attend your regions’ first quarter meetings that are being held in March and April.

Lastly, I’d like to inform you that your year-end 2017 quality measures dashboard as well as a new cost and utilization dashboard will soon be distributed to you electronically and via your Quality Consultant. Our teams have put a lot of time and effort into making these reports more meaningful, and welcome your continued feedback to improve these.

Thank you for your time and commitment to Signature Partners, and I look forward to seeing you at the Annual dinner which is scheduled for May 8th; details to follow.

Sincerely,

Matthew Poffenroth, MD, MBA

CEO/CMO, Signature Partners

 

Letter from CEO/CMO

Dear Colleagues,

As you read through this final 2017 edition of the SPN Newsletter, I’d like to call your attention to two key areas where Signature Partners has been working diligently to help support your efforts to manage patients – the high risk care management program led by Tonya Kirchmyer, and the tremendous efforts to produce and distribute accurate quality measure reports led by Susan Peldo-Metzler, Susie Smith and Dr. Neeta Goel. We recognize that both of these initiatives are critical to our success, yet have faced numerous challenges to fully implement. As with most worthy causes, however, persistence is the key, and both of these programs are now nearly fully developed. While Tonya continues to recruit nurse care managers, she has developed work flows and assigned care managers to each of our practices. The care management team has reviewed hundreds of high risk patients and has impacted the care of several of those in a positive way. I trust you will begin receiving more communication from the team as they strive to support you. In regards to quality reports, after struggling through three changes in ownership of our data warehouse vendor (now Koan Health), our Quality and IT Analytics team are finally ready to begin distributing quality measure gap reports on a routine, quarterly basis. I can’t emphasize enough how much time and effort has been dedicated by the Signature Partners team to get you accurate and meaningful reports. Several of you have provided feedback along the way which has been tremendously helpful as well.

Lastly, I’d like to reassure you that all of this effort is not without reward. As you are aware, we received and distributed a sizeable gain-share payment to our providers from Innovation Health earlier this year, and hope to have a similar or better payout in 2018. In addition, we have several other value-based contracts either in place or being negotiated, including our contract with Johns Hopkins Health Care for USFHP (TriCare Prime) which is exceeding growth targets, a new Innovation Health Medicare Advantage program which will launch in January 2018, and ACO contracts with three other commercial insurance carriers. All combined, these programs will offer significant value-based incentives for our providers as we all work together to improve the cost and quality of health care for these patients. As we finalize these new payor agreements, your quality consultants will be reaching out to you to educate you on the programs.

Thank you for your commitment to Signature Partners, and I look forward to a very successful 2018.

Sincerely,

Matthew Poffenroth, MD, MBA

CEO/CMO, Signature Partners

Letter from CEO/CMO

Dear Colleagues,

It gives me great pleasure to announce that Signature Partners earned a shared savings payment of $931,291 for 2016. This payment is based on a total cost of care for our attributed patient population that increased at a trend of 2.1% for 2016, compared to the “market trend” (non-Signature Partners) of 8.9%. In a nutshell, this means that PCPs in Signature Partners controlled cost significantly better than non-Signature Partners. Thanks to all of you for your hard work!

Based on our board-approved shared savings allocation model for 2016, gain share payments are being made to practices with 20 or more attributed Innovation Health members, and are based entirely on attribution, with no variance based on quality. In 2017 and beyond, quality performance will be factored in as well.

For 2017, we will have 3 “must pass” quality measures to access any shared savings, which you should be aware of. These include: 1) Hemoglobin A1c testing completed in 89% or more of our diabetic patients, 2) 300 or more “high risk” patients enrolled in care plans, and 3) completing a coding audit of 3 charts per provider. If we don’t pass all three of these, then we will not earn any shared savings bonus. In addition, because of the criteria for clinical integration and the need to collect quality metrics, gain share payments will be limited to those practices which are either on an EMR, or will be on an EMR by the end of 2017.

What can you do to maximize your bonus in 2017?

  1. Make sure you review your quality, utilization and “gap reports” with your assigned quality improvement coordinator on a quarterly basis.
  2. Outreach your diabetic patients and make sure they have an A1c test complete during the year.
  3. Refer any high risk patients for care management to your assigned Signature Partners care manager.
  4. Allow our coding team to access your records to complete the coding audit.
  5. If not on an EMR, or unhappy with you current EMR, contact Signature Partners to discuss implementing AthenaOne.
  6. Most importantly – maximize our gain share amount by keeping total cost of care down:
    1. Educate your patients to avoid the ER except for true emergencies
    2. Provide same-day access for patients with urgent matters
    3. For any patient that is hospitalized, follow-up with them in your office within 2 – 5 days of discharge
    4. Prescribe lower cost generic medications when possible
    5. Avoid unnecessary testing, imaging and specialty referrals

It is important to realize that although we kept cost down in 2016, we have significant opportunities to keep them down even further in 2017 and 2018. We must all do our part to practice high quality, cost efficient medicine, which will be rewarded by additional value-based payments. This payment for 2016 should be considered only a small taste of what is possible.

Thank you again for your participation in Signature Partners, and congratulations for earning this payment for 2016. The entire team looks forward to working even harder with you to achieve the triple aim for our patients.

Sincerely,

Matthew Poffenroth, MD, MBA

CEO/CMO, Signature Partners

CEO/CMO Letter

Dear Colleagues,

As you read through this first quarterly newsletter for 2017, you’ll find that the team at Signature Partners has been incredibly busy as we continue to develop the network in an effort to bring added value to our physician members while striving to drive improvements in quality and cost of care. Perhaps most importantly, with 2017 being the first reporting year under MACRA, we have been developing our strategy for how to position our providers to maximize their performance under this new governmental program. As you’ll read in greater detail below, all providers within Signature Partners Medicare Shared Savings Program (MSSP) will meet the reporting requirements under MIPS in 2017, thereby avoiding a penalty and being eligible for a fee schedule increase of between 0.1% – 4.0% in 2019. We are also in the process of evaluating various “advanced alternative payment models” for 2018, and will likely be applying to begin a track 1+ MSSP. We’ll have more information on these programs in the coming weeks and months.

I am also pleased to announce that at the beginning of the year, Signature Partners became a member of CAPG, the largest national association of physician groups with over 250 large physician groups and networks from around the country, several of whom have been engaged in risk contracting for many years. As a member of CAPG, we will be participating with their annual Standards of Excellence certification program, which will help us assess our strengths and weaknesses as a clinically integrated network, and how we compare to our peers. One of the other values is access to a variety of educational programs and webinars which we will be able to make available to our providers.

As you know, one of the foundational reasons for developing a clinically integrated network is to drive improvements in quality, cost and experience of care, thereby bringing value to patients and payers. We’re very proud to announce that Signature Partners has earned the trust of Johns Hopkins Health Care to become their first and only provider network in Northern Virginia, allowing them to market their Uniformed Services Family Health Plan (USFHP), which is an exclusive agreement with the Department of Defense for a TRICARE “Prime” product. This spring, Signature Partners and Johns Hopkins Health Care will begin jointly marketing this product to over 100,000 TRICARE members in Northern Virginia, bringing new patients and opportunities to earn value-based payments to our providers.

Lastly, we’re excited to announce that Signature Partners has executed a contract with athenahealth® for their electronic medical record and revenue cycle platform, which we can now offer to our providers at a very competitive rate. athenahealth® is a top ranked ambulatory EMR and billing platform that will not only help providers succeed in their day-to-day practice operations, but will also help Signature Partners succeed in the area of population health, as we will be better able to capture key quality and utilization metrics. For more information on how to learn more about athenahealth®, please see below.

Thanks to all of you for your participation and engagement.

Matt Poffenroth, MD, MBA
CEO/CMO, Signature Partners

Signature Partners Annual Dinner Held March 2, 2017 – Video

Signature Partners held its third Annual Dinner on March 2 at the Inova Center for Personalized Health. Thank you to those of you who were able to attend. We hope you enjoyed a lively conversation with athenahealth® and found the keynote address on MACRA and MIPS by Donald Crane beneficial.

 If you were not able to attend, we are including a link to the video of the evening’s presentations below. Hope to see you next year!

Watch Video

Message from CMO

Welcome to the Spring edition of Signature Partners News. The first quarter of 2016 is off to a great start, as we’ve welcomed 36 new primary care physicians and 61 new specialists to the network, with several other providers soon to follow. I’d like to extend a special welcome to Dr. Armani and Dr. Sileo who recently joined us from Privia Medical Group. For names of the other providers who have joined, please refer to the “Signature Partners News” section within this newsletter.

As Signature Partners grows we have embarked on several key quality initiatives that I’d like to share some updates:

1) To comply with the Medicare Shared Savings Program, we successfully completed reporting to CMS for Measurement Year 2015 on all 22 quality measures, protecting our participating providers’ Part B claims from a negative adjustment in Payment Year 2017. Our clinical quality and satisfaction scores will be published on our website in 3Q2016.

2) As recommended by our PCP Advisory Council, we have hired staff into a Quality and Clinical Integration role. This experienced group of clinical quality facilitators is currently visiting primary care practices to introduce their role, our quality initiatives, and discuss clinical integration.

3) Our Advanced Illness and Geriatrics Program is scheduled to launch in June. This program is made up of 4 elements:

  • SNFist Program – deploying providers to a select group of high quality SNFs, with which we will contract to manage our post-acute care patients
  • Advanced Illness Clinic – located at the IMG Oakton office, this clinic will serve as a medical home to our most medically complex patients who require more time and services than typical primary care offices can offer
  • Geriatrics Assessment Clinic – co-located with our advanced illness clinic, board-certified geriatricians will provide consultative services for patients with complex geriatric conditions
  • House Calls Program – teams of providers (MD/NP/SW) will provide comprehensive primary care for house bound patients with advanced and complex illness

Lastly, I’d like to invite you to join us at our Annual SPN Provider Dinner on June 9th at the Inova Center for Personalized Health . Our keynote speaker will be Blair Childs, SVP of Public Affairs for Premier Healthcare Alliance, who will speak about how the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will impact physicians. Signature Partners is committed to helping our independent primary and specialty care physicians to succeed in the era of payment reform, and the MACRA legislation will be a driving force which all providers should understand. I look forward to seeing you all at the dinner, and hearing about your concerns.

 

 

Signature Partners