Value Based Services

Value Based Services

THS will create the infrastructure to support and manage personnel to take on risk-bearing contracts. We will provide advisory and consultative services around building strong and functional relationships with the hospitals at which your Physicians practice. This includes creating point person (other than the CEO) to be the Liaison, and crafting strategy in each market to ensure alignment and positioning to leverage your relationships. THS will work to structure, negotiate and manage a co-management agreement for the Orthopedic service line (or sub-specialty Service line) within the hospital(s) the group operates in.

Service Description
Coordinated Care team development Develop team/positions needed to operationalize VBS
Identify key team members Recruit or re-purpose existing staff for VBS team
Roles and responsibilities Educate PT regarding VBS and clinical responsibilities related to contract
Internal workflow Develop an internal workflow with all departments that will be part of VBS
Utilization Review Train UR in process needed for VBS contracts
Business Office Develop / train BO in VBS contact payment process as relates to internal workflow
Physical Therapy Dept. Educate PT regarding VBS and clinical responsibilities related to the contract
DME Develop/train regarding DME process as relates to VBS contract
Clinic Staff Training Train entire office clinical staff regarding VBS / operationalize
Navigator Training Training of Navigator as per VBS contract
Clinical Staff Presentation development Specific power point for training of office stafft
Hospital Presentation development Specific power point explaining VBS for hospital audience
Patient Education Material Development of all patient education materials
Surgeon Selection Facilitate surgeon selection as per VBS contract
Surgeon / PA Education THS Credentialing department manages provider enrollment for Commercial and Governmental payers; manages hospital privileges, reports and maintains Continuing education requirements, national supplier clearinghouse enrollments.
Surgical Order Set Development Develop clinical protocols / pathways with participating surgeons
Travel Program Development Develop a travel program for VBS patients traveling for the surgery
VBS Financial Tracking Operationalize system to track VBS AP/AR as per VBS contract
Hospital / Facility Selection Identify hospitals for VBS contact
Coordination of Hospital / Facility Services Coordinate services between provider and hospital as per VBS contract
Hospital /Facility EMR Place Surgical Order Set into facility EMR
Phone Huddles Establish scheduled phone meetings with payer and facility partners
Payer Workflow Develop workflow with payer for all information regarding the VBS contract
Prospective Specific workflow for prospective contracts
Retrospective Specific workflow for retrospective contracts
Inclusion / Exclusion Criteria Develop specific clinical inclusion/exclusion criteria for each VBS contract
Patient Medical Records Develop workflow to collect patient medical history from payer or TPA
 


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