Prospective Providers

inVio Health Network is a physician-led, clinically integrated network of providers, including Prisma Health employed and independent physicians, healthcare providers, and hospitals who work together to coordinate care across the continuum and deliver the greatest value for our patients: high-quality, cost-effective outcomes.

As a patient-centered performance improvement organization, the network strives to:

• Integrate quality initiatives across the network.
• Accelerate the implementation of advanced clinical technologie.
• Reduce underuse, overuse and misuse of clinical resources.

The network uses a collaborative model that empowers providers to build a healthcare delivery system designed to succeed in a value-driven environment. This model includes a Board of Managers that provides leadership and oversight, along with committees focused on improving and standardizing care. Committees are composed of network providers and administrative staff who represent the communities the network serves.

By placing leadership and decision-making in the hands of providers, the network ensures that clinical quality remains at the forefront of care. The network’s structure also allows providers who are not employed by a hospital to remain independent while participating in a large provider network. In addition, our broad geographic footprint strengthens our ability to manage populations for government payers and large employers whose members reside in multiple communities – resulting in greater access to care and choice of providers.

Network participants receive the tools and operational support needed to meet the industry’s evolving demands and succeed in an at-risk, value-based environment. These resources help providers improve health outcomes, reduce healthcare costs, and enhance the patient experience. Network staff engage payers and insurers in innovative payment models while monitoring and measuring cost and quality.

No. inVio Health Network will not purchase or manage your practice or hospital. Our goal is to bring physicians, hospitals, and other healthcare providers together to improve health outcomes, reduce healthcare costs, and enhance the patient experience.

First, because network participation is voluntary, providers must sign a participation agreement.

Second, participating providers are expected to collaborate with other network participants to develop and adopt clinical initiatives that enhance the quality, service, and cost-effectiveness of patient care.

Finally, providers must hold themselves and one another accountable for compliance with network initiatives. This accountability includes adherence to clinical care models, quality and process monitoring, and remediation efforts should a provider not meet the standards of quality patient care established by the inVio Health Network board and committees.

Sharing data on measures included in the network’s Clinical Integration Program is a condition of participation. It enables quality data to be aggregated across the network in order to:

• Follow how our patients are being cared for across multiple settings.
• Give credit to all providers connected to a patient when a quality measure is met.
• Track network-wide data for all population health quality measures. Specialists can contribute to meeting these measures even when they are not assigned to their specialty (e.g., tobacco use, blood pressure control, body mass index, depression screening).
• Improve performance for the network as a whole and increase opportunities to earn shared savings and quality bonuses.

inVio Health Network eligibility criteria include, but are not limited to:

• Have a current license to practice in South Carolina or Tennessee.
• Be eligible to participate in federal healthcare programs, including, without limitation, Medicare and Medicaid.
• Bill payors electronically for both inpatient and outpatient activities.
  • Participate in care improvement initiatives developed by the network.
  • Agree to share data for measures that are part of the network’s Clinical Integration Program:
    • Population health measures: These measures are included in network contracts with payers. Provider performance data is collected through a direct electronic medical record (EMR) feed.
    • Network measures: These additional measures are important to improving quality across the network. Because the data needed to calculate them may not be available from practice EMRs, it may be sourced from acute care hospitals, registries, or practice billing systems.

The agreement is executed with the practice; however, insurers and other payers may also require signatures from individual physicians. Each practice determines internally how its members will participate in inVio Health Network, fill committee and leadership roles, and distribute performance bonuses. A practice must sign a participation agreement to be included in the network.

No. To ensure consistency across all hospitals, practices, and providers, the agreement is not negotiable. If you have questions about the agreement, please contact Anna Kay, Vice President, or Kim Roberts, Executive Director Network Operations, at Anna.Kay@inViohealthnetwork.org or Kim.Roberts@inViohealthnetwork.org.

No. While inVio Health Network seeks to create opportunities that may not be available through your individual or group contracts, it does not replace all payer contracting.

The network pursues select shared savings and value-based payment opportunities with payers that complement, rather than replace, your current contracting arrangements.

No. inVio Health Network enables otherwise independent physicians, hospitals, and providers to approach payers collectively to contract for innovative care delivery models, such as shared savings programs. The success of these arrangements depends on each payer’s willingness to reward improved quality through financial incentives, and on each provider’s ability to achieve the quality and efficiency goals of inVio Health Network.