Physician and Provider Frequently Asked Questions

We recognize and respect that patients are welcome to choose any entity they wish for post-acute care. Patients and their families often look to us, their caregivers, to provide options we believe are in their best interest. Through the formation of the CCN, we now have partner entities we can recommend with confidence. These partners are dedicated to the same 'triple aim' goals we are: better quality care, reduced per capita cost, and higher patient satisfaction. These participating entities have undergone site visits, clinical review and analysis, and have met stringent quality requirements. They also currently report monthly to our Accountable Care Organization (ACO) Quality Committee to ensure these standards are scrupulously maintained.

Participants were chosen through a lengthy and rigorous review process that considered:

• Historical quality and performance measures and results meeting or exceeding median for federal quality standards
• Easy access, geographic proximity, and clinical capacity to care for our ACO beneficiaries
• Compliance with federal and state regulations
• 30-day hospital readmission rates at or below national or Washington state norms
• Patient satisfaction ratings at or better than median reported for Washington state
• Patient/family engagement

Additional credentialing standards specific to skilled nursing facilities were also applied.

CCN providers and entities are required to demonstrate ongoing quality and performance through monthly metrics reporting to our ACO Quality Committee. Failure to meet the established expectations of quality may result in suspension or removal from the network beginning on or after July 1, 2014.

Performance data for the CCN providers will be available beginning July 1, 2014. At that time we will also launch a public website to provide additional information about the CCN, performance measures and results.

Absolutely. ACO beneficiaries will always be able to see their own physician while recovering in a participating CCN facility. Our FNPHN CCN physicians and nurses are specially trained and qualified to work with patients in post-hospital care settings, and look forward to partnering with you in their care.

Participating CCN providers are required to communicate with individual beneficiary physicians at specific transition points during a patient’s care:

• Transfer from hospital to post-acute setting
• Transfer from one post-acute setting to another
• Transfer from post-acute setting to home

Individual physicians may additionally expect ongoing communications during a patient’s stay in any setting or facility. Beneficiaries are never “removed” from the care of an individual physician at any point in the process. The model of physician coverage within the CCN will parallel that of a hospitalist in an acute hospital setting, whereby physician coverage is ensured for those patients whose physicians are unwilling or unable to follow a patient outside a clinic setting.

FNPHN receives no additional payment or compensation for those ACO beneficiaries who receive their care in a CCN facility. There are no fiscal or monetary penalties associated with the CCN.

CMS Conditions of Participation requirements mandate that we offer choice to Medicare beneficiaries. We recognize and support patient and family choice. Patients may choose any skilled nursing facility or home health agency they prefer, regardless of whether or not the facility or agency is part of our Continuing Care Network. As they often look to us to provide options we believe are in the best interest of their loved one, we now have partner entities we can recommend with confidence.

Working with these partners will help ensure improved communication and processes at all points of patient transfer, provide better outcomes and value for our patients, and help reduce readmissions to our hospitals.