GSQN is the largest physician-led, quality driven, clinically integrated network in the State of Louisiana that allows independent and hospital-employed physicians to collaborate with the goal of improving the quality of patient care offered while reducing costs.

 

Clinical integration is collaboration among healthcare providers to develop active and ongoing clinical initiatives that are designed to control costs and improve the quality of healthcare services. Participation in an effective clinical integration program provides physicians the ability to contract collectively with employers and benefit plan administrators who recognize the value of high quality healthcare.

 

As a member of GSQN, you will become part of a physician-led, physician-driven program that is helping lead the movement toward clinical integration throughout Louisiana.  GSQN provides several opportunities to help you become successful.  Members of GSQN:

 

  • Collaborate on a much higher degree with focus on quality of care, not quantity;
  • Can participate in the identification and development of quality metrics to provide best practice pathways of care;
  • Gain economic benefit for delivering high-quality cost effective care based on best practices;
  • Help eliminate inefficiencies to reduce cost;
  • Have access to quality measures via an interactive online database;
  • Help introduce a new product to the marketplace that focuses on value and best practice delivery, which could drive business to your practice; and,
  • Continue your independent status, while having visibility to and participation in the clinical integration process.

Membership is completely voluntary.  If you choose to participate, you will:

  • Sign the Gulf South Quality Network Participation Agreement and Business Associate Agreement.  This agreement specifies the details associated with participation in the program.
  • Complete physician application
  • Hold yourself and your colleagues accountable for compliance with the initiatives of the program, including disciplinary and remediation efforts should physicians not meet the benchmarks set by the GSQN Quality Committee.

The physician-led Quality Committee selected a number of physician practice measures for both ambulatory and inpatient care.  You will be encouraged to participate in the measure selection process for your specialty as requested by the Quality Committee.  In addition, you will be expected to log in and review your data in the technology tool(s) selected to house clinical data on a monthly basis at a minimum.

 

No, the Gulf South Quality Network is a non-exclusive organization with no limitations on your ability to admit patients to non-collaborating sites, or maintain contracts with health plans, another non-clinical integration program, or IPA affiliation.  However, the legal requirements of clinical integration require that we capture sufficient quality data that represents a meaningful sample of your practice.  If a high volume of your care is delivered at non-collaborating facilities, it may be difficult for you to report on care delivered in those facilities and, therefore, to meet the quality standards of the program.

At this time, you may maintain agreements with health plans with which GSQN does not contract.  As GSQN engages in negotiations with payers, we will seek a collectively-negotiated partnership with additional pay-for-performance and shared savings incentives.  GSQN does not negotiate fee schedules on behalf of the physicians.  Participation in the Gulf South Quality Network requires your participation in all clinically integrated health plan contracts that it enters, and you will not have the ability to opt out of these health plan agreements and still remain in the Gulf South Quality Network.

 

GSQN assists you in improving patient outcomes by providing you with information on areas of opportunity.  Your participation in the quality and care management initiatives that are identified may require time and attention from you and your office staff.  In return, you will be eligible to obtain financial rewards for your achievements through the clinical integration program.  The amount of any incentive payments will depend on both your personal score and the overall score of the organization. This latter component highlights the importance of physicians working together in an interdependent manner to improve care.

 

An ambulatory EMR is not a prerequisite for this program.  At a minimum, you must have access to the internet and process claims electronically.  Gulf South Quality Network is working with software vendors who have streamlined the data collection process to make it as easy as possible on practice operations.  

As defined by the FTC, a “qualified clinically integrated arrangement means: …an arrangement to provide physician services in which:

  1. All physicians who participate in the arrangement participate in active and ongoing programs of the arrangement to evaluate and modify the practice patterns of, and create a high degree of interdependence and cooperation among these physicians, in order to control costs and ensure the quality of services provided through the arrangement; and,
  2. Any agreement concerning price or other terms or conditions of dealing entered into by or within the arrangement is reasonably necessary to obtain significant efficiencies through the joint arrangement.” (Statements of Antitrust Enforcement Policy in Health Care by the FTC and the U.S. Department of Justice, Statement 8).

Currently, there is no fee to physicians to participate.

Partnering with a hospital can provide distinct advantages to a network of independent physicians in the development of clinical integration.  In instances where the hospital shares the same quality vision as the physicians, the hospital can be a powerful ally in the program development by:

  • Collaborating with physicians in the development of clinical integration initiatives based on existing inpatient quality measures;
  • Lending financial assistance and personnel in the implementation of inpatient and outpatient initiatives that provide true community benefit and are not tied to the volume or value of referrals; and,
  • Demonstrating to payers and the community as a whole that clinical integration is both legitimate and valuable.

We understand that some patient cases are more complex than others.  You will only be measured against those member physicians who are handling similar medical cases.  In addition, the process is collaborative with your regional peers and not punitive.  However, meeting and/or exceeding specialty specific target goals is required for maintaining eligibility for your complete portion of the bonus incentive reimbursement.

All GSQN physicians must log on to the GSQN website (www.gsqn.org) and view their data monthly, at a minimum. A notification will be sent to the physicians on the 20th of every month to check their quality data.

Yes, you can access www.gsqn.org from any computer, as long as you know your username and password.

Contact the quality analyst at your local hospital and they will review your data and questions with you.

Please contact the quality analyst or program manager at your local hospital, and they will be happy to work with you as you move through the system.