Equality Health’s Practice Performance Managers (PPMs) are central to supporting physicians and practice staff engagement in the transformation of practice workflow to better align with participation and performance in value-based reimbursement programs. We recruit and deploy PPMs who understand how practices have historically functioned in fee-for-service models, and have experience in transforming practices to sustainably operate as high-performing value-based care (VBC) oriented businesses.
PPMs: Driving Improvement, Decreasing Burden, Delivering Quality Care
Proving Success by Measuring Results
The success of Equality Health’s PPMs is measured across a range of metrics including user adoption of Equality Health’s proprietary value-based care technology platform and how the practice performs under their VBC agreements. PPMs can achieve transformative results by helping practices understand and implement value-based care and achieve the triple aim of improving the patient experience, lowering costs of care, and improving health outcomes of the patient population.
Equality Health Network practices that are most engaged, as measured by technology platform utilization, consistently exhibit better performance on both quality and cost management initiatives. For example, costs of institutional claims for one representative health plan were consistently 20% lower in practices in the high engagement cohort vs. those in the low adoption cohort. Quality performance was similarly improved through engagement, with the high engagement cohort demonstrating improvement of seven-day follow-up rates after hospitalization by 176%, while Well-child and Adolescent Well-child visit completion rates improved by 10 and 20 percentage points, respectively.*
Professionals You Can Trust
Equality Health’s PPMs are a key liaison between provider practices, the health plan payer, and Equality Health resources and services. As such, PPMs bring important interpersonal skills — persistence, adaptability, and conscientiousness — when working and building trust with healthcare providers. Our PPMs are trained for cultural competency and reflect the diversity of the communities we serve. Most hold a degree in healthcare or business-related fields, have managed quality (HEDIS, STAR, etc.) and have transformed practices under value-based contracting agreements. Most have previously worked as:
- Practice administrators
- Office managers
- Medical assistants
- Health coaches
- Social workers
As part of our high-touch engagement model, our PPMs visit their assigned practices at least one time per month, and as frequently as weekly for practices with a higher volume of patients or higher practice needs. They build trusting relationships with physician practices (practice managers, providers, and office staff) to support engagement with Equality Health’s model.
When aligned with a provider practice, our PPMs will lead an onboarding process that includes the facilitation of a series of training sessions. Training sessions delivered during the onboarding process include:
- An introduction to culturally competent care
- Instruction in the use of Equality Health’s proprietary value-based care technology platform
- An overview of the four domains of Equality Health’s model for VBC (Practice Operations, Clinical Care Coordination, Practice Transformation, and Quality Management)
Following the onboarding activities, our PPMs provides practices with support and guidance as they begin to reprioritize practice workflows around value. Most practices are adept at managing the patients who seek care and present at the office, but others may need assistance managing attributed patients across an entire panel, which is required to succeed in VBC payment models.
Using Equality Health’s proprietary value-based care technology platform, the PPM teaches the practice to systematically close gaps in care, accurately and appropriately document the health status of members, and establish protocols and workflows for managing referrals to high-value specialty care — including behavioral health. This workflow transformation gives practices, when they are ready, the ability to confidently assume and manage financial risk for the total cost of care.
Equality Health’s PPMs deliver and review the practice’s quality and efficiency performance on a quarterly basis, and provide expert guidance on ways to continually improve that performance. Simultaneously, they deliver the practice’s value-based incentive payments. This connection between reporting and financial incentives reinforces the connection between value-based care delivery and value-based financial compensation.