2021: A Busy Year of Successes
Despite malingering COVID impacts throughout 2021, the PACN had many notable achievements. Our network
leadership shifted to nimbly meet the increased performance demands in seven value-based payer contracts
covering 61,000 lives. We are proud to have such a highly talented and effective management team as noted
below which includes Bruce Roscher as our new Chief Operating Officer. In addition, the PACN has steadily
improved outcomes in many metrics as our network physicians learn how to better gain recognition for the
excellent care our practices already provide to their individual and collective patients.
It’s Crunch Time. Year End Quality Focus
As we approach the final days of the year, many of us are in a “flurry of activity” working tirelessly to satisfy
identified gaps in care for the 2021 Quality Performance year. We recognize and appreciate the cooperation
and dedication that many of you have demonstrated in our combined efforts to improve our overall Network
Performance. Please be aware of the following critical health plan deadlines: Uploading or sending documents
to close care gaps must be completed by December 31st (exceptions: Gateway 12/10/21, Aetna 12/29/21, CBC
1/14/22, Humana 2/14/22). Claims or CPT II codes can be submitted through 12/31/21 for Gateway &
Geisinger, 1/31/22 for CBC & Highmark, 1/10/22 for UPMC, 2/14/22 for Humana, and 4/6/22 for Aetna. If you
have any questions or need any assistance, please contact your Director of Clinical Outcomes.
Preparing for 2022.
Looking forward, the PACN is well positioned to meet the increased performance demands of 2022 and
beyond. The network just received final CMS approval for our PACN-ACO to participate in Medicare Shared
Savings Program (MSSP) upside only track for 2022. Our robust self-governed Committees are growing to
better guide the ACO portion of our network and welcome additional committed physicians for 2022. We are
also growing our Quality Team with a Clinical Transformation Consultant to increase the valuable outreach to
your practices to achieve even more quality recognitions next year.
New Partnerships to Help Your Practice
The PACN team is working to establish unique partnerships with multiple organizations that will bring new revenue opportunities to your practice and help to improve patient care. These include laboratory services, remote patient monitoring, and behavioral health. Be on the lookout for more details in the coming weeks!
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Community Care Grant! Congratulations to our PACN practices that were awarded the PAMED Community Cares grant! This $4M grant to improve community care was made possible by the relationships that Highmark developed with the PACN in their True Performance Quality...
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