Provider-Led Workgroups

Practice Management and Administration Council

• Frequency: This is currently a monthly workgroup.
• Purpose: Bridge the gap between clinical and payment policy with operations. Provide a holistic approach by inviting non-practitioner stakeholders to the table.
• There are currently 34 members in the council ​and we are open to new members! Members should be in the role of practice manager or administration.
• This group is currently tracking systemic concerns and meeting to discuss research completed (with resolution) or in progress​.

Medical Policy Workgroups

• Frequency: This is a quarterly workgroup.
• Purpose: Complete Health Network organizes groups of medical experts to vet the plan’s medical policy. Second, physicians sit on the plan’s board of directors, and they endorse any recommended changes to the policy. 
• Five speciality-matched medical policy workgroups

1. Obstetrics
2. Primary Care
3. Pediatrics
4. Emergency Medicine
5. Behavioral Health

• Read on about our Provider-Led Medical Policy, including priority areas and accomplishments from each group.

Quality Management Committee

• Frequency: This is a quarterly committee
• Purpose - Provides oversight and direction in assessing the appropriateness of care and service delivered to CCH, and to continuously enhance and improve the quality of care and services provided to members. This is a Senior Leadership level  committee that approves and reviews all quality functions and provides oversight of all quality sub-committees such as pharmacy, med management and delegation oversight.  
• Provider Requirements - Requires at least four (4) network providers representing the range of practitioners within the network and across the regions in which the health plan operates, e.g. family practice, internal medicine, OB/GYN, behavioral health, vision/dental care providers, and other high-volume specialists as appropriate.
• The provider representatives should have experience caring for the CCH membership, including a variety of ages and races/ethnicities, rural and urban populations, etc.