ChesterCountyMedicineSummer2020 - 12

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A Status Report
BY JAAN SIDOROV, MD, CEO & PRESIDENT, PA CLINICAL NETWORK

I

n 2018, the Pennsylvania Medical
Society's subsidiary, the PA Clinical
Network, signed a participating
agreement with the 180 physicians and
advance practice clinicians of Women
and Children's Healthcare Alliance. Made
up of independent pediatric practices
in southeast Pennsylvania, this clinically
integrated network was the first evidence
that the Medical Society could support
physician contracting.
This early success gave the PA Clinical
Network the momentum it needed as it
fanned out across the state to approach
other independent physicians. Eventually,
it signed up another 158 physicians and
providers, all of whom are in private
practice and keenly interested in working
together to increase the value of health care
and be fairly compensated for their work
effort.
Once a critical mass of physicians had
been achieved, the PA Clinical Network
and its sister organization, the Women
and Children's Alliance, approached
Pennsylvania's insurers for network
contracts. These negotiations took months,
not only because of their complexity, but
because Pennsylvania's insurers had never
seen a network made up of independent
physicians band together in this way.
Eventually, six contracts (Geisinger Health
Plan, Aetna, Gateway, Capital BlueCross,
Highmark and Humana) were inked by
the PA Clinical Network, and a separate

pediatric-focused contract was developed
by Women and Children's.
All the contracts described above are
in-force for 2020, and the PA Clinical
Network staff are hard at work developing
the systems and processes necessary for
physician-support, including information
technology, care management and staff
coaching. The information technology
includes HealthEC, a population health
platform that can work with any electronic
health record to summarize, analyze and
display key outcomes at the clinic as well as
at the network levels.
It should be noted that when the total
number of independent physicians and
providers who have been assisted by the
Society's networks is added to the prior
count of physicians and providers who
were helped with meeting the ill-conceived
MACRA law, the total is 492 practitioners.
Without the assistance of the Medical
Society, many of these private practice docs
would have retired or sold their practices.

The Coronavirus
The PA Clinical Network and the
Alliance are well underway in meeting
the terms of their contracts. When the
coronavirus pandemic occurred, however,
staff pivoted to supporting our network
practices. Our activities included distilling
the insurers' contradictory and shifting
guidance on telehealth coding, working

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with the insurers to shift their guidance,
sharing information on financial assistance
programs, connecting clinics to PPE
suppliers, disseminating best practices
and developing marketing materials to
support the safe return of in-person care.
In contrast to the dire reports and rumors
of physician practices going under, every
member of the PA Clinical Network is
still open for business. Since none of the
Network physicians are employed by any
health systems, they have been relatively
unaffected by the significant financial woes
that have driven many hospitals to seek
bailout money.

The Role of the County
Medical Societies
All politics and healthcare are local, and
the same is true for physician networks. As
we continue to fan out across Pennsylvania
in search of like-minded physicians, we
have found that a connection to the county
medical society - in contrast to PAMED
- is a strong predictor of interest in the
PA Clinical Network. Little wonder.
These physicians are already engaged, are
independently minded and are interested
in working with their colleagues at the local
level.
In addition to local "networking" for
the Network, we have worked with the
counties at a business level. One example is
Allegheny County Medical Society, which
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