Hackensack Meridian Health Partners CIN

Hackensack Meridian Health Partners is a physician-led clinically-integrated network, made up of private and employed-HMH physicians to better coordinate care, improve clinical care and align better around value-based contracting. For more information, contact: Amy Gallagher
Phone 732-765-6335
amy.gallagher@hmhn.org Kerry Kenna
Phone 732-765-6336
kerry.kenna@hmhn.org

Richard Morris
Phone 848-888-4693
richard.morris@hmhn.org

Resources

HealtheAnalytics, HealtheInsights, and other HMHP & Lumeris Resources

FAQs

Many health systems are partnering with physicians to create clinically integrated networks to prepare for performance-based pay and accountable care. Establishing HMHP and partnering with our affiliated physicians to improve hospital quality will ultimately generate value – better quality at lower cost – for patients, their families, and employers.

Many independent physicians, including both primary care physicians and specialists, still prefer to remain in private practice. By offering access to favorable contracts, performance-based bonuses, credentialed referral networks, and care management resources, HMHP helps independent physicians gain financial stability and remain in private practice if they desire. Independent physicians who join HMHP have the opportunity to be considered “Tier 1” providers for patients that are covered by health plans who HMHP has negotiated value-based contracts with.

The majority of the board members are independent physicians. Of course physicians lead the clinical enterprise for HMHP, determining membership of the physician network, setting quality standards and creating the clinical programs that will drive the quality and cost-effectiveness of care.

HMHP’s goal is to provide the necessary infrastructure, management, and contracting support that will enable physicians to focus on clinical integration and the improvement of care. This includes negotiating and executing population health contracts that support value-based health care, providing information technology support, working with physicians on performance incentive programs, and promoting physician leadership in HMHP governance.

HMHP will not purchase or run your practice. The goal of HMHP is to bring physicians, hospitals, and other health care providers together to improve health outcomes, reduce health care costs, and enhance the patient experience.

Independent physicians in good standing on the medical staff of at least one Hackensack Meridian Health hospital are encouraged to apply for network membership.

All the physicians in the practice must participate. A practice must sign a participation agreement to be included in the network.

Narrow provider networks seek to offer lower premiums by limiting the group of health providers available to plan enrollees.

Tier 1 patients benefit by having access to high-quality care at lower out-of-pocket costs.

Tier 2 patients can incur greater out-of-pocket costs.

HMHP does not restrict physicians from participating in other networks. However other pay-for-performance provider agreements may require that physicians participate in only one agreement for a specific payor. For example, a primary care provider may only participate in one Medicare incentive program. Similar restrictions may apply to commercial health plan value-based payment models.

While HMHP will seek to create opportunities that may not be available through your individual or group contracts, it will not replace all payor contracting.

HMHP recognizes that payment for health care will cover a broad continuum of different models that include bundled payment, pay-for-performance, shared savings, and risk. We do not anticipate physician participation in full-risk contracts until we have more experience with these different payment models. When we are ready to enter into full risk contracts, you have the ability to elect not to participate in a full-risk contract.

The current participation agreement was discussed at length by the HMHP Board and physicians members’ comments and concerns were addressed to arrive at a fair agreement. In an effort to maintain consistency across the network, the agreement is not negotiable. HMHP leadership will continually review the agreement and determine if changes are needed based on feedback received from providers. There are very broad, flexible termination provisions in the agreement to protect the physicians.

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