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Bryan Health Connect Annual Report 2022

A year of change and renewed purpose

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President's Message
John Findley, MD, CPE

john findley

Dr. Findley

In my discussions with many of our members over the last year, it is apparent that we all continue to struggle with the lingering effects of the COVID-19 pandemic – staffing, supplies, reimbursement and burnout. I think we can all agree, health care delivery was already complex enough! The added fears of the unknown have most definitely made it harder to derive meaning and purpose in our daily work.

Over the last year, I have watched my own family members navigate a messier and more broken health care system. Without having me to advocate on their behalf, the likelihood of adverse events was unacceptably high as they transitioned between hospitals, specialists, imaging, labs, rehab, etc. These experiences have only amplified my enthusiasm for our shared vision to make health care delivery better. Our work is not done until we get it right for every patient, every time – no exceptions!

Joseph Campbell once said, “The cave you fear to enter holds the treasure you seek.” You all have stepped into the cave and have done many truly heroic things for patients in the last few years…without seeking recognition or reward, but simply striving to make a difference one patient at a time. That is the secret treasure. An antidote to the stressors we face each day, one that drives meaning and purpose. The patient stories shared with the Bryan Health Connect team over the last year are a constant reminder of the difference you make, one patient at a time.

We would like thank our membership for their dedication to the health and wellbeing of our patients, and to recognize their efforts. We know that you are truly committed to making a difference.

We celebrate the successes and the amazing work that you have done, and continue to do, every day.


Chief Medical Officer's Message
Jessica Heckman, MD, FAAP

Jessica Heckman, MD, FAAP

Dr. Heckman

It has been an honor to complete my first full year of tenure as Chief Medical Officer for Bryan Health Connect. I have appreciated being part of an auspicious organization with a diligent team. It is through their continuous efforts that we have been able to put forth a number of new educational opportunities for all clinical staff members of Bryan Health Connect. Through our meetings, I have come to know several of the providers who support Bryan Health Connect, and I have been continually impressed by their commitment to improve the lives of their patients.

Quality metrics and education have been a pronounced effort to engage our members, particularly with a three-fold focus on hypertension, advance care planning and colorectal cancer screening. A lecture series and educational handouts for both providers and patients have been a cornerstone to the increased offerings we strive to create for our members. Our clinical campaigns have not only allowed providers to claim maintenance of certification credits, but have also offered free approved educational units for CMAs, LPNs and RNs.

We also have a number of patient-directed educational materials such as the Five Wishes advance directive document, which allows patients and their families an easier path to make their health care decisions known. Bryan Health Connect will continue to expand the focus and manner of educational and general support to our members. It is my utmost goal to continue to listen to our members’ needs and provide assistance to them in the best way possible as we continue to move forward, together.

PHO Membership

Bryan Health Connect membership includes a licensed health care providers representing a wide variety of specialties and primary care.

Our members practice across many diverse practice settings including independent and employed physician and advanced practice provider groups, Rural Health Clinics, Critical Access Hospitals, non-Critical Access Hospitals, ambulatory surgery centers, imaging centers, dialysis centers, durable medical equipment members and telemedicine services.

Bryan Health Connect recognizes that the only way to improve the delivery of care across its broad geography is to bring key stakeholders together to define and guide a shared agenda. We value the diverse views and importance of every members’ interests being represented.

Member Growth

  • 2018 - 1,267
  • 2019 - 1,404
  • 2020 - 1,474
  • 2021 - 1,616
  • 2022 - 1,877

Member Composition

  • Individual Providers - 1,877
  • Private Practice/Groups - 280
  • Critical Access Hospitals (CAHs) with rural health clinics- 24
  • PPS Hospitals - 3

Facility Members

  • Dialysis Center of Lincoln
  • Doctors Outpatient Surgery Center
  • Home Dialysis of Lincoln
  • Lincoln Digestive Health Center
  • Lincoln Endoscopy Center
  • Omega Surgery Centers
  • Physicians Surgical Center- Health and Neck Surgical Partners
  • Southwest Lincoln Surgery Center
  • The Nebraska Ambulatory Surgical Center
  • Urology Surgical Center

New Members in 2022

  • Bryan Physician Network Clinics
    • Prairie Center Internal Medicine & Nephrology – Grand Island
  • Anesthesia Nebraska – Lincoln
  • Carlson Psychiatric Services – Lincoln
  • Center for Psychological Services – Kearney
  • Central Nebraska Rehabilitation Services – Lincoln
  • Contemporary Obstetrics & Gynecology, PC – Kearney
  • Diabetes Supply, An AdaptHealth Company (Durable Medical Equipment Provider) – Omaha
  • Foundations Family Health – Lincoln
  • Grand Island Clinic – Grand Island
  • Hastings Radiology – Hastings
  • Inpatient Physician Associates – Grand Island
  • Kearney Regional Medical Center – Kearney
  • Live Well Counseling Center of Greater Nebraska – Kearney, Grand Island, York, Broken Bow
  • Lincoln Physical Therapy & Sports Rehab – Lincoln
  • Makovicka Physical Therapy – Omaha, Lincoln, Gretna, Bellevue, Bennington, Papillion
  • Nebraska Cancer Specialists – Grand Island, Hastings
  • Nebraska Peace of Mind Behavioral Health – Lincoln
  • New West Sports Medicine & Orthopaedic Surgery – Kearney
  • Pender Community Hospital – Pender
    • Emerson Medical Clinic
    • Pender Medical Clinic
    • Beemer Medical Clinic
    • Bancroft Medical Clinic
  • Platte Valley Medical Clinic – Kearney
  • Preferred Anesthesia – Lincoln
  • Salvati LLC – Lincoln
  • SH Psychiatric Services – Lincoln
  • Teledigm Health/ Bryan Telemedicine – Lincoln
  • Vitalize Health, LLC – Lincoln

Impact Across the Region

Membership extends across several states, and is growing.


Operational Changes

Bryan Health Connect continues to invest in resources and expertise to expand and support the many services we provide to benefit our members. We are continually seeking to improve processes to ensure our member experience is the best possible. The following is a brief summary of improvements:

Our People

We are growing and modifying to bring more value to our members. We welcomed Kyle Barlow, DHA, as Vice President of Payer Contracting, Angi McAndrew as Credentialing Specialist and Tina Ryan as Quality Improvement Advisor. Tera Heidtbrink, MSN, was promoted to Value-Based Care Operations Manager and Wanda Kelley, MSN, was promoted to Physician Hospital Organization Operations Manager.

Sherry Radford, MSN, joined the team as Population Health Services Manager with a focus on care management growth and innovation. She brings more than six years of experience guiding Bryan Health’s efforts to help patients navigate a complex health system. This represents our ongoing investment in the necessary expertise and resources to successfully managing risk as we evolve in to a clinically integrated network. Care management is central to excellence in all versions of value-based care from commercial Alternative Payment Models to Direct-to-Employer agreements. Sherry and her team add a valuable resource for members committed to improving care across the continuum.

Our Processes

The following processes have been enhanced: new member onboarding, primary source verification for membership application and payer enrollment approvals, and membership dues invoicing.

New Member Onboarding

Refinement of the membership onboarding procedures has been an important focus to ensure that new members understand all of the benefits and responsibilities of being a part of the Bryan Health Connect network of providers. Maintaining positive member relations is important to us. Staff routinely meets with members to get to know them and their practice, answer questions and share member benefits.

Primary Source Verification

With the goal of ensuring that BHC’s provider members are of the highest quality, we partnered with the Primary Source Verification (PSV) arm of the Council for Affordable Quality Healthcare (CAQH).

Primary source verification is a process by which a provider’s reported credentials and qualifications, such as board certification, undergo a first-hand confirmation. This venture was completed at no additional costs to our members.

Not only does the PSV process ensure our member providers meet high-quality industry standards, but is part of our strategic plan to bring forward delegated credentialing opportunities in the future. We appreciate all of our members who have kept their CAQH profiles current for this process.

Credentialing Policies & Procedures

Our payer credentialing policies and procedures process was developed under the guidance of legal counsel to ensure our procedures follow proper National Committee for Quality Assurance industry-standard guidelines.

  • Highlights of new policies include:
    • Updates to the minimum threshold criteria for membership application
    • Restructuring of BHC Credentialing Committee responsibilities
    • Primary source verification completed with the Council for Affordable Quality Healthcare (CAQH)

Membership Dues & Invoicing

The Bryan Health Connect Board of Trustees, at their May 11, 2022, meeting approved revisions to the membership dues and invoicing process effective January 1, 2023. This was the first dues increase since 2014 and will remain in effect until January 1, 2025.

To simplify processes:

  • Member dues were separated into three PHO membership types: Provider, Facility and Ancillary.
  • Dues invoicing cadence changed from monthly to annually beginning January 1, 2023.
  • New providers added throughout the year will not be invoiced until the following year.
  • Refunds will not be issued for termed providers throughout the year unless approved by BHC.

Managed Care Payer Contracting

Bryan Health Connect welcomed Kyle Barlow, DHA, to our team as Vice President of Payer Contracting. He brings several years of industry knowledge and expertise, and will lead BHC’s overall payer strategy, which includes establishing, negotiating and administering payer agreements.

We are excited to share a few highlights from the past year with managed care and direct-to-employer payer agreements offered to the membership.

New BHC PHO Contracts 2022

  • Commercial
    • Nebraska Total Care Ambetter
    • Bright Health
    • Kawasaki
    • Medica Elevate
    • Oscar
  • Medicare Advantage
    • Medica
    • WellCare
    • UnitedHealthcare VBC
    • Aetna VBC

Payer Claim Escalation Process

  • Bryan Health Connect implemented a new Payer Claim Escalation Form to streamline the process for member claim issues with payers. This is available to members via the BHC website.
  • BHC expects payers to pay according to the contract. Our goal is to help with reimbursement issues once the claims escalation process between clinic/provider and payer has been exhausted. After the insurer’s process for claims dispute has been followed and resolution cannot or has not been reached, Bryan Health Connect will advocate on behalf of the facility/provider for resolution.
  • Certain criteria must be met by the member before involving Bryan Health Connect through submission of the Payer Claim Escalation Form. BHC will work with the payer to resolve the issue(s) raised which may include connecting the payer representative and the clinic via email and/or a meeting to resolve the issue.

Rural Reimbursement Committee

Recognizing that a large number of our members support rural Nebraska, we endeavored to bring more value to these members. In 2022, the Rural Reimbursement Committee was established. This is an ad hoc committee of members appointed by the BHC Board of Trustees. The primary responsibility of the Rural Reimbursement Committee is to be the representation within Bryan Health Connect from rural health facilities for commercial reimbursement concerns, commercial payer issues, access to services, and potential strategic employers to partner with and any additional information that better positions Bryan Health Connect to better meet the needs of rural hospitals.


Member Education & Events

An educated network is an empowered network. We continue our commitment to bring timely and relevant educational topics forward throughout the year.

Visit the BHC website to view our educational webinars.

2022 Educational Offerings

  • No Surprise Act Webinar | February 15, 2022
  • BHC Spring Member Forum | March 17, 2022
  • Billing & Coding Workshop | May 11, 2022
  • BHC Annual Membership Meeting | May 12-13, 2022
  • BHC Fall Member Forum | August 25, 2022
  • Hypertension Management: Tricks of The Trade webinar | September 21, 2022
  • Living Without Colorectal Cancer webinar | November 1, 2022
  • Show Me Your MDM: Successfully Implementing the 2023 Updates to E/M Service Selection webinar |November 30, 2022
  • Putting Advance Care Planning on the Agenda webinar | December 8, 2022
  • BHC Winter Member Forum | December 15, 2022

Patient and Provider Resources

BHC is committed to keeping members informed about the rapid changes occurring in health care and strives to provide resources and tools to our members to implement best practices to improve patient outcomes while decreasing cost.

The ACO created a variety of educational resources for members to distribute to their patients, and also resources and videos for provider education.

  • Care Management
  • Annual Wellness Visits
  • Advance Care Planning
  • Quitting Tobacco Products
  • HPV Vaccines
  • What is an ACO?
  • Daily Self-Check: Asthma
  • At Home Blood Pressure Monitoring: How to Measure Accurately
  • What is High Blood Pressure?
  • What Can I Do to Improve My High Blood Pressure?

You can find these and other resources here.

Clinical Campaigns

BHC launched a series of Clinical Campaigns designed to improve quality of care with a team-based approach, particularly while being cognizant of staff time and effort. Each clinical campaign offered educational materials and a webinar by a subject matter expert with the opportunity to earn continuing education credit. Participants in the Accurate Blood Pressure Measurement Campaign also had the opportunity to earn grant funding for the purchase of blood pressure equipment.

Campaigns Offered

  • Campaign 1 - Accurate Blood Pressure Measurement
  • Campaign 2 - Advance Care Planning
  • Campaign 3 - Colorectal Cancer Screening

Collaborating with community, state and national initiatives provides BHC the opportunity to share evidence-based best practice tools and resources throughout our membership. These best practices can then be implemented into workflows to ensure our population of patients is receiving the best quality of care and health outcomes.


Member Services

Bryan Health Connect strives to offer quality products and services that our members use in their daily business operations. Our goal is to help you save time, money and resources.

Medical Malpractice & Liability Insurance - COPIC

COPIC is the premier member service provider, offering exclusive benefits to BHC members:

  • Leading medical liability insurance provider
  • Nationally recognized education activities that meet your needs
  • Customized education programs
    • In-person
    • On-demand
    • Specialty specific activities
    • Lunch and learn seminars
  • Online library of education courses and medical tools
  • On-site reviews that integrate best practices and address high risk areas
  • 24/7 access to risk management hotline
  • Premium discount available only to Bryan Health Connect Members

Delegated Payer Credentialing - Nebraska Health Partners

Bryan Health Connect offers delegated credentialing through Nebraska Health Partners (NHP) to provide members with primary source verification and payer enrollment services with several contracted payers and commercial payers, including Medicare and Medicaid enrollment.

Group Purchasing - Provista

Provista (part of Vizient) is a group purchasing powerhouse that actively works with multiple companies’ purchases to be able to offer low prices on products and services to members to reduce costs and streamline their procurement processes.

Continued Education & Tuition Assistance - Bellevue University

Bryan Health Connect, in partnership with Bellevue University, offers generous tuition reimbursement allowances. This is a benefit offered to organizations who are members of Bryan Health Connect, and includes the organization's employees and their family members.

Through this partnership, you are eligible for up to:

  • $10,500 per year for full-time Bryan employees
  • $5,250 per year for part-time Bryan employees
  • $3,000 per year for non-Bryan employees
  • $2,500 per year for immediate family members

Financial Consulting, Accounting, Tax & Tech - Lutz

Lutz’s specialized health care consulting group focuses on an array of services for health care providers including Medical & Dental Practices, Rural Health Clinics, Critical Access Hospitals, and Hospitals & Health Systems. Our talented team of CPAs and consultants have over 125 years of combined health care experience. Whether you want to automate your systems, manage your business needs through outsourcing, or find ways to improve procedures for timely and accurate financial information, our dedicated team of experts are ready to help.

Online education training and tracking - careLearning

careLearning is an online education company designed to help health care organizations by providing reliable, trusted and easily-accessible talent management solutions. Competency, eLearning and performance products are developed to ensure that your employees are provided with the appropriate training and education based on an assessment of the skills, knowledge and abilities required, and evaluation of their job performance.

careLearning Learning Management System offers course packages and private course libraries that you can customize to fit your group’s needs. Member groups with less than 30 employees can receive special pricing on certain products.

Debt Collection - Clear Recovery

Clear Recovery offers an exclusive collection fee and a resolution-based approach designed specifically for health care.


ACO Membership

Bryan Health Connect ACO, LLC, is excited to celebrate the success of our Accountable Care Organization (ACO) in its fifth year.

Shared Savings

Throughout 2022, Bryan Health Connect ACO continued to focus on our foundational purpose and build upon successes from previous years. The unrelenting determination to move forward in our mission to drive cost-effective population health improvement with the ambition of Every Patient, Every Time is evident by the impact made to the patients and communities we serve. This is accomplished through the continuous advances of operational processes leading to delivery of high-value care. With the support and collaboration of the many dedicated professionals involved, we were able to again demonstrate success, not only in shared savings, but saved lives.

Significant progress has been made to integrate our member providers, hospitals and private practices to work together using proven protocols and measures to improve the health of our patient populations by supporting value-based care and the Quadruple Aim. Medicare, Medicaid, commercial insurers and employers are recognizing BHC as a valuable partner.


Value-Based Contract Successes

  • Blue Cross Blue Shield of Nebraska Shared Savings. We have again qualified for a significant amount of shared savings dollars from our Blue Cross Blue Shield of Nebraska (BCBSNE) value-based contract. BHC attained 21/26 points for meeting quality measure benchmarks for the contract year that ended June 30, 2022. This is well above the 10 points required to be eligible for shared-savings. This success allowed us to distribute shared savings to our participating providers for the third consecutive year.
  • 2021 CMS Medicare Shared Savings Program ACO Participant Report. We are pleased to note that our quality score for 2021 improved from the previous year and has moved up in the rankings of all Nebraska ACOs. We also contributed to the total dollars saved per benchmark by CMS for 2021, the most recent year reported, and obtained shared savings within our third year in the program allowing us to distribute additional funds to our ACO participants.
  • 2021 Merit-Based Incentive Payment System. Based on 2021 reporting of a combination of quality metrics, promoting electronic medical record interoperability and quality improvement activities, as a result of their performance our providers will receive a 2.33% increase to the fee schedule for 2023.

Value-Based Contracts

CMS MSSP

ACO Value-Based Care Agreement
  • Performance Year January 1-December 31, 2023
  • Level D - Shared Savings with Downside Risk

Blue Cross Blue Shield Nebraska

ACO Value-Based Care Agreement
  • Performance Year January 1-December 31, 2023
  • Shared Savings with downside risk and quarterly care coordination payments

Nebraska Total Care

ACO Value-Based Care and Incentive Program
  • Performance Year January 1-December 31, 2023
  • Shared Savings with downside risk and quarterly care coordination payments
  • Incentive based on quality metric performance, Continuity of Care and Risk Gate

BCBSNE

Medicare Advantage

Incentive Program ONLY
  • Performance Year January 1-December 31, 2023
  • Incentive based off gap closures with bonus for entire ACO gap closure > 80%

NEW

Wellcare

Medicare Advantage Incentive Program ONLY
  • Performance Year January 1-December 31, 2023
  • Incentive based on quality metrics performance

NEW

Medica Elevate

ACO Value-Based Care Agreement
  • Performance Year January 1-December 31, 2023
  • Shared Savings – only includes Bryan entities and Saunders in 2023 with plans to expand to more counties and AQCO participants in 2024

NEW

UnitedHealthcare

Medicare Advantage Incentive Program ONLY
  • Performance Year January 1-December 31, 2023
  • Incentive based on quality metrics star performance4 (MA-PCPi), Medical Condition Assessment (MCAIP), Annual Care Visits

NEW

Aetna

Medicare Advantage ACO Value-Based Care Agreement
  • Performance Year January 1-December 31, 2023
  • Upside only year 1
  • Very limited downside risk starting in year 2

Value-based contracts negotiated in 2022 for January 1,2023 effective date.


ACO Growth

Bryan Health Connect ACO began the onboarding process for three new ACO participants. Onboarding and access to support launched for these new ACO participants in October 2022 to assist in building a solid foundation for their start date of January 1, 2023. We are delighted to welcome the following new ACO participants!

These members went through the onboarding process in Fall 2022:

  • Howard County Medical Center - St. Paul
    • Howard County Medical Clinic
    • Greeley Medical Clinic
  • Kearney Regional Medical Center-Platte Valley Medical Clinic - Kearney
  • Pender Community Hospital - Pender
    • Bancroft Medical Clinic
    • Beemer Medical Clinic
    • Emerson Medical Clinic
    • Pender Medical Clinic

We are grateful for the many opportunities we have had to work with our members. Bryan Health Connect continues to improve processes, embark on new initiatives, celebrate many accomplishments and welcome additional staff members.


Learn More about Bryan Health Connect

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