Quality Initiatives

HN1 has implemented numerous initiatives that focus on maintaining high physician involvement, satisfaction and quality. Some of the unique features that HN1 provides to its contracted providers and payers include:

  • Geo-capitation reimbursement model to its physicians. Under HN1's model, providers act as the gatekeeper for specialty services, thus significantly reducing Part A expenses that would otherwise be incurred by the payer under a FFS structure. In addition, geo-capitation creates high satisfaction for both physicians and members due to the reduction in referrals/claims processing and increased continuity of care.
  • Extensive UM/QM programs including:
    • In-house quality management committee headed by an HN1 Medical Director of that medical specialty
    • HN1 physician steering committee for each medical specialty
    • Provider credentialing
    • PCP, specialist, and member satisfaction tracking
    • Development of practice guidelines in accordance with curren accreditation standards
  • Toll-free numbers for member and physician inquiries
  • 24-hour access to participating providers with highly trained personnel to triage emergency referrals
  • Provider Credentialing on behalf of its contracted payers
  • Concurrent review of medical records, surgical outcome analysis, and encounter reporting
  • Ongoing analysis of office wait times, appointment scheduling, and emergency coverage

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