UniNet Kearney Chapter

Leadership

Leadership

Ken Shaffer 

UniNet's Kearney chapter was formed in 2013, and we've focused on creating clinical initiatives that will help local providers achieve the triple aim: improved health of the population, decreased per capita cost and improved patient experience.

My hope is that the clinical, financial and claims data that UniNet provides will help you practice more efficiently. I'm here as a resource for you; please contact me if you would like to discuss any CIN issues, activities or programs.

- Ken Shaffer, MD, UniNet Kearney Medical Director


 

Committees

Credentialing Committee

  • Dr. Mark Mowry
  • Dr. Dennis Edwards
  • Dr. Kenton Shaffer

Patient Services

Care Coordination

Care coordination in a patient-centered medical neighborhood involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient's care to achieve safer, more effective care. The coordination involves communication among everyone involved with the patient, including hospitals, doctors, nurses, pharmacies, physical therapists, and the patient.

UniNet Kearney works closely with CHI Health Good Samaritan to contact individuals who have been discharged from the hospital.

  • A registered nurse ensures that the patient understands their discharge instructions and was able to receive prescribed medications after their hospitalization. 
  • The nurse discusses any other needs that may have arisen since they returned home and makes sure they can follow-up with their primary care physician. 
  • An electronic system communicates this information to other members of the individual’s care team. 

UniNet Kearney uses a bilingual Certified Social Worker trained as a Community Health Worker to address any socio-economic needs of patients in the community, using a Pathway Model developed in Ohio by Dr. Mark Redding.  

Diabetes Health Hub

UniNet Kearney collaborated with Buffalo County Community Partners to provide services to 250 diabetic patients over the past three years using a Community Health Worker to help patients address barriers that negatively impacted their ability to manage their health care condition. 

Program outcomes included: 

  • CHI Health Good Samaritan Emergency Room use for patients enrolled in the program showed a $1,139,103 decrease in ER costs.
  • Ninety-four percent of the 168 patients that needed a primary care provider (PCP) secured a formal relationship with a PCP. However, 73 percent of the 168 clients reported cost as the biggest barrier to continuing care, which illustrated the need for a free community clinic. The HelpCare Clinic opened in May 2015.

Learn more:

Buffalo County Community Health Access Team

Health Education/Living Well

UniNet Kearney's Health Education program encourages consistent and evidence-based health education throughout the continuum of care, from home to clinic to hospital, and empowers individuals to become better managers of their overall health.

Living Well Classes

Living Well is an evidence-based Chronic Disease Self-Management program developed by Stanford University. The program is an interactive workshop consisting of six sessions that help people with ongoing health conditions learn real-life skills for living a full, healthy life. Participants learn how to take small steps toward positive changes and healthier living. The workshop helps to build participant confidence and improve their ability to manage day-to-day life with a chronic disease.

Clinical Initiatives

UniNet Kearney also facilitates health care teams focused on clinical initiatives that encourage community and patient involvement. These initiatives provide networking and connections to other community resources, which helps reduce patient barriers.

Home Monitoring for Heart Failure

UniNet Kearney offers at home monitoring for reporting vital signs. Studies show that individuals monitoring their own blood pressure, weight, oxygen saturation, and blood sugar demonstrate increased ownership of their health and better stabilization of their illness. 

UniNet Kearney leases Honeywell electronic home monitoring devices, or patients can use equipment that they already have at home. Individuals use the monitor and associated peripheral devices to take their blood pressure, weight, and oxygen saturation, which is automatically transmitted to a web-based database. Any vital signs that are outside the standard parameters are reviewed by the heart failure nurse; a follow-up telephone call determines if an individual needs to be seen by their health care provider.

UniNet Kearney also provides heart failure calendars for manual daily documentation of vital signs and education on heart health topics such as medication, diet, and activity level. The individual calls their vital signs into UniNet Kearney and the heart failure nurse works with the individual and their health care provider to better manage their health. 

Medication Access Program

Applying for prescription assistance programs can be complicated and time consuming for patients due to varying qualifications, criteria, and processes with each pharmaceutical company.

UniNet chapters in Kearney and Omaha offer a prescription assistance program to help physicians and their patients navigate the pharmaceutical company application process for many brand-name medications. These programs are called Medication Access Program (MAP) in Kearney and Prescription Assistance Program (RxAP) in Omaha.

RxAP/MAP Services can include:

  • Determine which pharmaceutical assistance programs a patient may qualify for, based on medication, income, and insurance status. RxAP works with approximately 15 different pharmaceutical company prescription assistance programs.
  • Help patients through the initial application, re-enrollment, and refill processes.
  • File appeals and research other sources of prescription support for those individuals with extensive medication needs that are not eligible for the traditional Patient Assistance programs.

In Kearney, the Medication Access Program helps fill 4,000 to 5,000 prescriptions for approximately 1,500 to 2,000 patients in a typical year. From July 1, 2003 to June 30, 2014, MAP provided more than 60,000 prescriptions with a total prescription cost of $26.3 million dollars. The average annual savings for patients in the Kearney community is $2.39 million per year.

UniNet Kearney providers and/or population health coaches can refer patients to the program.

Provider Services

Provider Relations

We understand that health care providers are being pressed to do more in less time. UniNet's provider relations team assists our members with a variety of payor matters, so that they can continue to focus on providing the best possible patient care.

UniNet's provider relations services include:

  • Payor contract negotiation and management
  • Provider and facility credentialing
  • Serving as a liaison between providers and payors for issues, questions and updates

If you are a health care provider or affiliated with a health-care facility interested in joining UniNet, please complete an application.

Delegated Credentialing

UniNet Kearney performs delegated credentialing for the third party payors with whom it is under contract.

  • An applicant’s credentials and professional background are verified for accuracy and completeness by contacting the direct source of the information. This may include checking residency programs, licensing agencies, and specialty boards to confirm that statements made by the health care provider about training, experience and other qualifications are legitimate, unchallenged, and appropriate. 
  • Once UniNet Kearney completes the primary source verification process for an applicant, the application is sent to the local Credentialing Committee for review and consideration. 
  • The provider is approved by the UniNet Board.  
  • Provider information is then provided to the third party payer for inclusion in their payor network.

Primary Source Verification (CVO)

UniNet Kearney performs primary source verification services for third parties (credentialing clients) using  national best practices and standards approved by the accrediting bodies of NCQA, URAC, the Joint Commission, AAAHC, and federal and state regulations.

These credentialing clients contract with UniNet Kearney to perform primary source verification for the client’s own purposes, such as the client’s medical staff appointments. UniNet Kearney creates an information file  which includes verification of the providers’ education, residency programs, etc.

UniNet Kearney does not advise any credentialing client as to whether it should (or should not) employ or appoint an individual to the client’s medical staff. Each credentialing client makes its own independent decision whether to appoint a physician or allied professional to its medical staff.

Clinical Initiatives

  • Call center
  • Care management integration
  • End-of-life care
  • Central Nebraska Prenatal Advisory Board pilot project