High Value Specialist Collaboration

WKCC identified a need to create a High Value Specialist (HVS) collaboration due to the rising health costs and the need to improve the coordination of care between specialists and primary care physicians (PCPs) to improve quality and beneficiary satisfaction, and to control costs by reducing duplicative services. WKCC is partnering with like-minded/value-driven specialists to implement a collaboration that:

  • Uses evidence based clinical and operational protocols contributing to highly-efficient, beneficiary centered care
  • Provides superior coordination with primary care physicians
  • Produces high quality outcomes across metrics relevant to each targeted high cost specialty
  • Enables capacity to effectively work with and respond to other members of cross-disciplinary beneficiary-centered care team 

 

HVS Requirements:

  • Agree to improve communication and coordination of care as outlined in the HVS Agreement
  • Use of contracted referral management system, Infina
  • Use of common lab (LabCorp) and radiology testing (Raleigh Radiology), subject at all times to beneficiary choice and clinical decision making 

To be considered for HVS inclusion, a set list of requested information is required to present to the WKCC Network & Credentialing (N&C) Committee for review: 

  • Practice name
  • Specialty
  • Location (s)
  • Services offered; pediatrics, adults, both
  • Number of physicians and mid-levels
  • Physician names
  • Where outpatient procedures are performed
  • Where inpatient procedures of performed
  • Tiering status (if applicable) with BCBS, UHC, Cigna, Aetna and plans accepted across all payers
  • Value proposition; what makes your practice a value-minded practice, beyond procedure costs?
  • WKCC practices with whom you currently work/co-manage mutual patients
  • Performance data as available
  • 3 letters of recommendation from WKCC providers you are currently co-managing patients with, or have previously co-managed patients with

 

HVS Provider Change Forms

USE THIS FORM IF...
Practice Inquiry A practice is interested in joining the WKCC Collaboration
HVS New Provider A new provider joins your practice
HVS Termed Provider An existing provider leaves the practice and is no longer billing through the practice’s Tax ID #