The Facts
What is SCQCN?
- SCQCN is a clinically integrated network (CIN) led and managed by physicians in the community.
- Clinical integration is a collaborative effort among physicians and hospitals to use evidence-based quality initiatives to improve the quality and efficiency of healthcare while controlling costs.
- SCQCN provides independent private practicing physicians the opportunity to contract collectively with fee-for-service health plans.
What SCQCN isn’t
- Capitation
- Led by the hospitals
- Physician employment
- Costly to physicians
- An agreement that will put individual physician fees at risk
- Health plan/payer
Why physicians join SCQCN
- Clinical integration is a proven method to improve the quality and cost of patient care.
- Independent physicians are able to jointly contract with health plans for commercial patients, with recognition for achievement of quality benchmarks.
- Physicians receive access to business intelligence information technology.
- Physicians also receive visibility across the full continuum of care.
Physician participation requirements
- Sign a Physician Participation Agreement.
- Agree to the quality initiatives selected and defined by local physicians.
- Participate in network negotiated contracts.
- Share quality data with SCQCN via the technology provided by the program.
- Be accountable for compliance with SCQCN policies and procedures.
- Comply with technology requirements.
- Have the ability to communicate via email.
Benefits of joining SCQCN
Membership in SCQCN offers physicians:
- Collaboration with other physicians who are committed to improve quality care and patient outcomes, as well as the efficiency of care provided.
- Access to a robust, effective, RN-led care coordination team to help identify and manage their high-risk patients.
- Free, no-risk training ground to collaborate with other physicians to learn to more effectively manage patients in the new healthcare environment.
- Support and staff education through regular Lunch & Learn meetings as well as one-on-one meetings with the QM nurse.
Contract benefits
- Qualifying members of SCQCN will receive a 3% increase to their Blue Shield of California PPO lines of business through 2021.
- Members of SCQCN have an opportunity for shared savings.
SCQCN management
- SCQCN is physician-led. Local physicians dominate the board of managers and make the decisions affecting how the network operates and funds are distributed.
- Organizational development funds are provided by Dignity Health Dominican Hospital to help sustain a robust local medical community to serve the residents of Santa Cruz County.
- Dignity Health has expertise in providing infrastructure and operations support for CINs. Today Dignity Health supports eight clinically integrated networks across three states, which covers 178,713 lives, include over 6,665 physicians and advanced practice clinicians and more than 44 hospitals (including partner facilities).
Zero enrollment costs
- There are no enrollment costs.
- There are no ongoing participation fees.
Did you know?
- Membership in SCQCN does not interfere with pre-existing health plan contracts or other clinical integration programs, accountable care organizations (ACO), independent practice associations (IPA), physician organizations (PO) or physician hospital organizations (PHO) in which physicians may already participate.
- SCQCN will focus on new and innovative payer agreements available only through SCQCN.
- Each potential payer agreement with SCQCN is carefully reviewed by the physician board to ensure it presents a real or potential benefit to physicians.
- Physicians can terminate their participation any time for any reason upon 90 days’ notice.
- All quality initiatives and physician criteria are developed in collaboration with SCQCN physician leadership.
- Any information shared with SCQCN is confidential. It is used to measure performance and identify opportunities for improvement, to assist in improving quality scores and for demonstrating the overall performance of SCQCN to the community.