Population Health Services Overview
MercyOne Population Health Services Organization (PHSO) has over 20 years of experience in population health and value-based contracting. Founded in 2012, MercyOne PHSO was created to leverage the organization’s experience in population health to expand into commercial and governmental value/risk-based programs. The portfolio has since grown to over 20 value-based agreements covering over 315,000 attributed patients throughout Iowa and neighboring states.
Since inception, MercyOne PHSO’s Partnered Provider Network has reduced healthcare expenditures for Iowans by more than $145 million by working together to improve health, increase patient satisfaction, and lower healthcare costs for members and the communities we are privileged to serve.
Improving health through social supports
Services we provide:
Partnered Provider Network: With more than 200 organizations that employ 4,500 providers, our network works as one to improve health and lower healthcare costs for members.
Clinical Integration: Our seven regional Chapters ensure a provider-led approach to population health and managing risk. Each region instills physician-led governance while balancing network-wide evidence-based standards through innovative care models.
Provider Enrollment: MercyOne’s Partnered Provider Network is maintained and updated monthly through credentialing and enrollment processes, ensuring accuracy of practice and provider information to reduce claim processing errors, improve attribution, and increase member satisfaction.
Compliance: With a statewide compliance network, MercyOne PHSO ensures up-to-date compliance standards are instilled throughout PHSO operations and across the Partnered Provider Network.
Ambulatory Clinical Documentation Improvement (CDI): Ensuring appropriate documentation and specificity of diagnosis is a key to success in value-based programs. With leading experts trained in numerous risk models, the MercyOne PHSO team of CDI Specialists provides auditing and education for providers.
Partnered Post-Acute Network: In addition to a traditional provider network, our network includes partnered post-acute providers who have demonstrated a commitment to high quality and low cost care.
Continuum Care Management: Our nationally acclaimed Care Coordination (Health Coach) Program is a core component of our PHSO model. Our team of 200 Health Coaches ensures seamless, coordinated care across the continuum to improve quality, increase satisfaction, and contain costs.
Risk Based Contract Management: Managing more than $2 billion of medical spend requires experience and infrastructure. With over 20 value/risk based agreements today, MercyOne PHSO has experience with the entire payer landscape; including Medicare, Medicaid, Commercial, Direct-to-Employer, among others.
Data Analytics: We understand ‘big-data’. With an industry leading ‘data-lake’ and analytics platform, Mercy PHSO brings together more than 400 different data sources for the most complete picture of population and patient health. This level of insight and reporting allows targeted intervention for performance improvement.
Customized Reporting: While we deliver industry standard reports, we understand that employers and payers may want a customized view. With a leading analytics team we have the flexibility to meet your needs.
Research & Grants: With a rich history in innovative models to improve population health, we offer our Partnered Provider Network access to research and grant development experts. This team continuously explores opportunities to fund innovation to redefine healthcare.
