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Advocate Health Network FAQ – Physicians

What is the St. Joseph’s/Candler Advocate Health Network?

St. Joseph’s/Candler Advocate Health Network, LLC launched in January 2017. The Accountable Care Organization (ACO) is dedicated to addressing the Three-part aim goals of improving outcomes, reducing costs and improvement of the experience for the beneficiary. The Advocate Health Network’s (AHN) physician participants of more than 550 represent both employed and independent physicians, with strong emphasis on primary care and coverage of key specialists who have a history of working collaboratively.

What is an Accountable Care Organization?

Accountable Care Organizations provide better, more coordinated health care to Original Medicare patients. An ACO is not a health maintenance organization (HMO), managed care or an insurance company. An ACO is a group of doctors, hospitals and other health care providers who communicate with patients and with each other to make sure each patient gets the care needed when sick and the support needed to get and stay healthy.

Who can participate in Advocate Health Network?

Advocate Health Network is for primary care and key specialty physicians. A participating physician must be a participating provider with The Care Network and maintain medical staff privileges at the in-network facilities, St. Joseph’s Hospital and/or Candler Hospital.

Why would physicians want to participate in the Advocate Health Network?

When physicians participate in Advocate Health Network, they are participating with a team of physicians committed to providing high-quality care, streamlining services and ensuring patient satisfaction and continually improving across each area. Being a part of AHN ensures doctors will work in a collaborative environment that improves conditions for patients and the doctors. AHN began participating in The Medicare Shared Savings Program (MSSP) effective January 2017. The Medicare Shared Savings Program rewards ACOs that lower their growth in health care costs while meeting performance standards on quality of care.

What are the responsibilities of St. Joseph’s/Candler Advocate Health Network?

The responsibilities of the St. Joseph's/Candler Advocate Health Network include:

  1. Commercial payer contracting on behalf of network physicians and hospitals.
  2. Payer compliance with payment terms of contracts.
  3. Distribution of funds generated from shared savings.
  4. Develop and maintain a network clinical utilization management plan.
  5. Data collection and integration for clinical, administrative and performance tracking purposes.
  6. Care management policies to support a culture of accountable coordination of care.
  7. Policies for tracking and managing chronic diseases through the use of patient care registries.

How much does it cost me to participate in Advocate Health Network?

There is no up-front fee or out-of-pocket risk for physicians to participate in Advocate Health Network. Provider participation in AHN is purely voluntary. Physician membership fees typically range from $500 to $1,500 taken from shared savings. That means if there is no shared savings, there are no fees. 

Do I need an Electronic Medical Record?

Yes, providers are responsible for furnishing their own Electronic Medical Record (EMR). Advocate Health Network will provide reporting of MIPS through the data bridge between the participating provider’s EMR and GE Caradigm. AHN will incur any costs associated with the interface.

How do I participate?

Ready to participate in the Advocate Health Network or want more information? Click here to fill out a form and someone within the organization will be in touch with you shortly.