Phoenix Children’s Care Network Reaches New Heights with URAC Accreditation

| URAC Staff
Toddler with teddy bear and stethoscope

A year after attaining URAC Clinical Integration Accreditation, the team at Phoenix Children’s Care Network (PCCN) continues to benefit from stronger and more collaborative relationships with service providers, alignment with the clinical integration standards, and significant interest from community physicians to join the network.

“The support I’ve seen [in the community] has been extraordinary,” says Carmen Neuberger, J.D., executive vice president, legal affairs and general counsel, Phoenix Children’s. PCCN became the first clinically integrated pediatric network to earn URAC accreditation in April 2017.

Accreditation has also engendered national attention and recognition for Phoenix Children’s accomplishment, Neuberger reports. “I just came from a national conference for general counsels in Dallas, and a number of other organizations asked me ‘how did you guys accomplish this?’ In many respects, we are ahead of the curve in our formation and evolution compared to other pediatric networks.  The accreditation also provided a new level of credibility, says Casey Osborne, PCCN vice president. “The accreditation was an integral part of an effort to provide greater transparency that payers, state and federal regulators appreciated. URAC accreditation has expedited our ability to move forward with our value-based models and integrated care efforts.”

Post-accreditation, Neuberger and Osborne work even more closely together. As a result, “we have confidence that we have achieved the necessary components to improve quality of care and increase efficiency and accountability across the network.  Validation by a reputable third-party entity such as URAC allows us to focus our efforts on these initiatives without constantly having to pause and check-in with outside counsel to reassess where we are,” Neuberger adds.

While Osborne expected accreditation to bring disparate operations more closely together, he’s been pleased to observe it’s had an even more positive impact than anticipated. “I think it’s definitely been good for us all to come together, with a common goal to improve outcomes and increase efficiency in care delivery.” That important collaboration has allowed the entire organization to “grow closer, more quickly” thanks in part to accreditation.

The seeds for that cohesion were planted early, years before the accreditation process started.  At the outset of PCCN, key leaders and physician stakeholders launched a physician advisory committee (PAC)to obtain buy-in and support among PCH physicians and community pediatricians and specialists. This allowed us to create a synergistic relationship with our physicians so that we could successfully launch our organizational structure. 

Looking back nearly a year after attaining accreditation, Neuberger found it intriguing to see that the PAC was “where we started building the key elements” of the clinically integrated network and helped the organization begin its path towards meeting the regulatory and accreditation requirements. These standards provided invaluable direction and guidance for our network,” Neuberger adds.

Accreditation has also helped PCCN find effective methods to share information. “We determined ways to exchange and share data so that we could better understand practice patterns and develop quality and efficiency metrics that we could then monitor for compliance and accountability,” Neuberger says.

Utilizing URAC Clinical Integration Accreditation requirements as a guide while observing FTC guidelines, PCCN was able to enter into contracts with managed care networks that provided incentives for improving efficiency while maintaining or enhancing quality.

PCCN has the structures and procedures in place that the FTC believes are necessary to improve quality and reduce cost, Neuberger explains. “This actually gives us some validation and credence with the payers, frankly, because URAC is an organization that accredits the payers themselves.”

Since achieving URAC accreditation last April, Neuberger has seen numerous benefits both direct and indirect. “Our organization is dynamic, and continues to respond to changing industry market conditions. URAC accreditation has made us more proactive and nimble and helped to provide the foundation necessary to move forward with what our objectives and our goals are for population management, care coordination, and value-based care.”

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