PROGRAMS FOR PRACTICES & PATIENT CARE

NEQCA’s Quality and Clinical Teams coordinate efforts to help the network achieve the Quadruple Aim goals of providing better health, better care, lower cost and improved provider satisfaction. NEQCA deploys resources and programs necessary for network physicians to achieve these goals.

These programs aim to improve care for patients such as those with diabetes and high blood pressure, as well as promote preventative care such as increasing well child visits and cancer screenings.

How does it improve patient experience?

The NEQCA Medical Home is led by the patient’s personal physician who works with a care team to coordinate continuous and comprehensive care.  For example, through the care management program, high-risk patients engage with a nurse case manager to learn how to manage their health and become active participants in their treatment.   

What does it mean for a physician practice?

The Medical Home helps to improve quality and efficiency performance, improve provider and staff satisfaction, and achieve Meaningful Use attestation for electronic health records and Patient Centered Medical Home National Committee for Quality Assurance (NCQA) Recognition Level II or Level III.

The goal of the program is to promote adoption and use of electronic health records to reduce cost and improve the quality and measurement of care. 

The NEQCA Medical Home Program includes three main components: Meaningful Use; Patient Centered Medical Home (PCMH) System of Care, and Care Management.

LEARN MORE ABOUT THE MEDICAL HOME PROGRAM

How does it improve patient experience?

NEQCA pharmacists help  NEQCA providers  optimize their medication prescribing  by developing preferred drug lists, providing the most cost-effective drug choices—reducing costs without sacrificing quality.

What does it mean for a physician practice?

Management of pharmaceutical costs offers great opportunity for more effective use of medical costs and quality. NEQCA’s Pharmacy Program deploys pharmacists to work with physicians to support LCO clinical initiatives by providing data and tools with the goal to improve optimal prescribing.  Pharmacists provide information about medications as new drugs are developed or new information (such as changes in labeling or market withdrawals) becomes available.

One of NEQCA’s most successful models for managing medical utilization while improving quality is the Care Alliance Integrated Care Management model.  The program focuses on patients enrolled in Medicare Advantage.

Key components of this model include care for complex patients, referral management, and frequent physician and team meetings to monitor and improve quality of care.

Proper medical coding and documentation practices are foundational in supporting the landscape of clinical information for providers and patients. NEQCA’s Medical Coding and Clinical Documentation Improvement (CDI) program works with NEQCA providers and their ancillary staff to ensure clinical documentation and medical coding meet the regulatory requirements set forth by government programs, medical organizations and commercial payors. NEQCA strives to assist network providers with achieving efficiency in clinical documentation and reaching maximum accuracy in medical code assignment. NEQCA’s Medical Coding and CDI program, offers a wide array of services for our physicians and their practices:

  • Review charts for code assignment accuracy
  • Offer a personalized practice assessment (infrastructure, coding, and documentation)
  • Provide feedback and auditing results to providers
  • Analyze chronic condition coding
  • Assist in transition from Fee for Service to Fee for Value
  • Provide training and education for physicians and staff
  • Act as a coding and documentation resource for providers
  • Help you learn the language of medical coding

At NEQCA, we realize that each practice is unique in their daily operations. That is why the Medical Coding and CDI program works with each practice to customize its services and trainings to best fit each physician organization. 

NEQCA's Healthcare Information Services (HIS) program is a strategic initiative designed to deliver high value care and provide a clinically-integrated platform that measures quality and performance.

To promote effective communications and engagement with patients, each EHR allows patients access to their health information from the internet through a secure Patient Portal. The Portal offers significant benefits for physicians and their patients. For physicians and their practices, the NEQCA Patient Portal provides the ability to securely communicate with their patients

SERVICES

NEQCA Account Managers serve as a resource and main contact to our network Local Care Organizations (LCOs) by providing information, education and support to LCO management, physicians and practice staff. The Account Managers support our LCOs and physicians in achieving success in the efficiency and quality initiatives required of our various payor contracts. 


NEQCA has a robust performance reporting and informatics system including a patient registry, as well as a claims and clinical data warehouse.

NEQCA provides analytical services centrally and on-site at Local Care Organizations. These services include report development and data interpretation that delivers critical information to physicians to help them plan for patient visits by flagging those patients who have not met treatment goals across a various quality measures. NEQCA analysts identify areas to deliver care more efficiently and help inform strategies that will allow the network and its physicians to achieve clinical goals.

Contracting and Payor Relations manages contracts on behalf of NEQCA by leading the negotiations and managing the execution and implementation of managed care contracts and expanding contract opportunities for our network.