We help you practice medicine
The practice of modern medicine now involves a complicated, changeable system of regulations, insurance and provider networks. Winchester Physician Hospital Organization (WinPHO) helps our providers deal with that system, allowing them to focus on what matters to them: their patients and their practice.
We offer a number of administrative and clinical services to take the burden from individual practices, including
- Negotiating insurance contracts for the best terms and reimbursement rates
- Ensuring payments are accurately distributed in a timely fashion
- Handling initial enrollment with contracted payors, including Blue Cross/Blue Shield, Harvard Pilgrim Health Care and Tufts Health Plan — the largest insurers in Massachusetts.
- Creating a larger referral circle
- Processing patient insurance referrals from PCPs and Specialists.
- Monitoring quality metrics and providing data reports aimed at improving patient experience and clinical outcomes
- Monitoring population health data and measures
- Providing resources for patient education, particularly for chronic conditions such as diabetes.
Quality performance is a major component of many payor contracts, including provider incentives for achieving standards of care in a number of quality measures relating to chronic conditions and preventive medicine.
Drawing on our collective experience in population health management, we will work with you and your practice to ensure you have the support needed to succeed, including tools to track and manage quality metrics, sharing of best practices and workflow analysis.
Your patients will benefit from quality initiatives aimed at preventive health maintenance care, as well as support with chronic care management. Physicians will benefit by improving the overall health of the populations we serve.
A strong provider network involves a collaborative effort to provide high quality, efficient and coordinated care to patients. Our referral management program is aimed at engaging patients and improving provider collaboration and communication.
Primary care physicians (PCPs) work within a network of providers with whom they have established relationships. This strong provider network provides high quality, efficient and coordinated patient care. The referral process strengthens and promotes the PCP/specialist relationship.
Key Benefits to the WinPHO network:
- Enhanced PCP and Specialist relationships within the Winchester Hospital medical community, promoting collaboration and continuity of care for patients.
- Affiliation with Beth Israel Lahey Health System enables better facilitation of tertiary care needs and improves coordination across different care settings.
- Physician partnership with Winchester Hospital, a top community hospital.
- Risk contract participation through the Lahey Clinical Performance Network, soon to be the Beth Israel Lahey Performance Network.