FAQ

Questions

Read our frequently asked questions

Yes, PCM is a network of affiliated financially and clinically integrated primary care physicians. PCM physicians are independent and not owned or operated by hospitals or health plans.
Yes. We are a network of physicians who have come together to successfully provide coordinated, high quality care to our patients as a Track 1 MSSP participant.
Existing IPAs are, for the most part, purely administrative. PCM offers a dynamic platform to meet the challenges of the market and provides population health services that are not currently available to independent physicians in the East Texas market.
Yes, its clinical integration program involves population health and data analytics to identify and stratify newly identified, well managed and end stage status, develop care plans and manage longitudinally in both pre and post acute stages.
No, we believe healthcare is managed locally for the community it serves. Its purpose is to be a sustainable long-term community asset.
As part of the contracts offered by the payors to PCM, we will receive payment from Medicare and other insurance plans for the provision of population health services for physicians and their attributed patients. PCM’s goal is to help physicians meet or exceed agreed upon quality standards and manage the population in a more cost effective way than the market.
PCM allows for you to remain independent and still enjoy the services and structure needed to be successful in the new value based world of healthcare.
In return for providing services to and through the Network, any surplus will be dispersed 60% to the doctors who are members and 40% to PCM to cover management and operational requirements.
It will be providing all the services and technology necessary to run the network. The only way for it to make money is for the doctors to make money, thus aligning incentives.
Yes, you will bill insurance companies directly on a Fee for Service basis, as you do now.
First, PCM as a whole has to save money for there to be a gain a share. If there is a gain share, the finance committee made up of physicians will establish a formula that is transparent to all members to decide how to divide the savings.
The physician executive board in conjunction with the management sponsor.
PCM with advice from the physician Board of Directors.
If not ready, PCM will provide information and services if needed to close gaps in readiness if desired by practice.
It is not a requirement at this time.
Over time that would be ideal, but is not a condition required for participation.
No, we help your practice actively participate in population health and collaborate with other independent physicians. In addition, if you choose, we can support you in chronic care management and care planning activity to grow and retain your patient base.
No, PCM will not have all insurance contracts in the market. For those contracts that PCM does not offer, a physician can contract as they wish.
Yes, all the PCPs under the groups tax id.