Advanced Practice Clinicians join Valley Preferred
With Advanced Practice Clinicians (APCs) covering such a large breadth and depth of knowledge, and types of training and expertise – Certified Nurse Midwife, Certified Registered Nurse Anesthetist, Certified Registered Nurse Practitioner, Optometrist, Physician Assistant, and Doctor of Psychology – Valley Preferred leaders wanted to provide them with the opportunities that the organization offers. Also knowing that APCs are many times the primary point of care for patients, they knew it was imperative to ensure APCs have valuable data and resources to advance care across the community.
Taking the time to do it right
Fortunately, Valley Preferred took the time to bring APCs thoughtfully into the organization. “We obtained guidance from a legally compliant standpoint,” says Mark Wendling, Executive Director, explaining that the process could have required re-filing with the state, which was not conducive to existing bylaws. Deliberation persisted and ultimately necessitated defining the requirements, building the agreements, and forming another designation within the organization. Beyond that, there was analysis, research, and testing among leaders, payers, and providers. “It took us nearly five years, but it would have been incorrect to rush it through,” he says. “We ended up with an offering that has the right methodology, is integrated with leadership, integrated into our organizational structure, compliant, and very well executed.”
The organization’s participation agreements have already been distributed and the numbers of APCs signing up have increased. There is an emphasis on APCs working in independent practices, as they can gain significantly from increased opportunities for professional development, business support, quality improvement education, payer opportunities, and having prompt answers to questions. “We want to make sure those at independent practices, who may not have had a lot of exposure to Valley Preferred previously, fully understand the many rewards of involvement,” says Dr. Wendling.
The importance of APCs in Valley Preferred
Looking to the future from a procedural standpoint, there are many reasons APCs in Valley Preferred makes sense, including these three.
- Clinical integration. There are currently about 900 APCs in Valley Preferred practices. For the purposes of clinical integration*, or an enterprise approach to coordination of care, APCs simply have to be represented due to sheer numbers. This is especially important as Valley Preferred continues to strive for performance optimization in a clinically integrated manner.
- Quality and value in practice. APCs are instrumental in pursuing and maintaining efforts that promote high quality care and high value. As we know, it is the responsibility of all members within a practice to work as a team to meet benchmarks and passionately work toward better care and better outcomes for patients. APCs are absolutely essential to this process.
- Contracts and payers. As the organization and its collaborations with payers increasingly rely on data and analytic insights, the large segment of providers represented by APCs is an influential component of value based care. By including APCs in Valley Preferred, analysts can roster them and get attribution counts that are more accurate. APCs can fold their attribution into their PCPs practice if they bill directly.
Just as outlining APC participation in Valley Preferred in a formalized way is groundbreaking, so are the nuances in contract discussions with payers. From the payer perspective, there is no singular methodology for viewing APCs. This opens up opportunities such as defining a model of care, apportioning patient populations, maximizing the ability to close care gaps, and potentially affecting episode costs. At the same time, their role within practices does not change. “While APCs are distinct and integral in Valley Preferred, representation on their behalf does not imply a segregation from the practice in terms of making decisions regarding payer opportunities, for example,” says Laura Mertz, Associate Executive Director. “We absolutely encourage practices to work as a team, and payers often require it.”
Physicians and other providers have embraced the addition of APCs. According to Dr. Wendling, this shows the high degree of professionalism Valley Preferred has come to represent after almost 30 years in existence. “Our physicians’ positivity and knowledge show how inclusive we are, and speak to our professional attributes,” he says. “It means we are an organization whose members have the utmost mutual respect for all of us who are a part of it.”
*The means to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, and patient-focused.