Emergency Department Partners

Managed Care Organizations

As clinical reimbursement continues to shift from a fee-for-service arrangement to a value-based model, physician alignment with managed care organizations (MCOs) is increasingly vital to long-term success and to achieving the triple aim of quality care, improved population health and reduced per capita costs. The goal of IES is to align ED operations and clinical quality with the objectives of MCOs and their patient populations.

Our key area of focus is transitioning the treatment of chronic illnesses from the ED to primary and specialty care with an emphasis on long-term wellness. Additionally, our provider teams are incentivized to control non-beneficial clinical variation which greatly impacts cost and patient outcomes. We achieve success in our relationships with MCOs by employing a model of trust, aligning incentives and setting goals based on data-driven insights.

Our approach to managing hospital EDs, urgent care facilities and observation units focuses on applying our value equation at each point of service across the continuum of care. We align the incentives of the MCO, hospital and provider group so they are centered on the best possible patient care at the best price. In addition, we focus on the hierarchy of needs in each ED we manage. It starts with:

  • A fully staffed ED
  • Insertion of core measures and peer review processes
  • Establishment of best practices
  • Limited practice variation
  • Collaboration
  • Quality culture

Through our 40+ clinical initiatives, we are uniquely positioned to manage the transition from fee-for-service to performance-based reimbursement models.