About Children's Mercy Pediatric Care Network: |
| Leadership |
| Who We Are and What We Do |
| Medicaid Managed Care Administrative Services |
| PCN Annual Report 2023 |
| Previous Annual Reports |
| Missouri PCN Network Providers |
| Kansas PCN Network Providers |
| Missouri PCN Provider Network |
| Kansas PCN Provider Network |
| PCN Service Area |
How does PCN improve health care delivery? PCN offers: |
| Simplified administration and reduced fragmentation with health plans |
| • standardized claim submission requirements |
| • standardized payment policies |
| • standardized utilization management policies (e.g. precertification requirements) |
| • standardized credentialing process |
| Better population-based clinical tools and medical home support tools |
| • Uniform model that doesn't force you to conform to multiple MCO models |
| • Tools and resources for care coordination at the practice level |
| • Health Information Technology tools (EMR, HIE) |
| • Aggregated data for the pediatric population in the Kansas City area |
| Payment system reform |
| • Transition from "volume based" payment with constant pressure on unit cost and volume of services to "value based" payment through common structure |
| • Opportunities for at-risk contracting, sharing savings, and other creative payment models |
| • Aligned incentives with the hospital and other providers |
| Delegated health plan administration |
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• Managed Care Organizations (MCOs) delegate certain administrative functions to us including medical management, provider credentialing, and disease
management programs. PCN uses a team-based approach to reduce barriers, export resources and expertise from Children's Mercy, and support patient- centered medical homes for the providers in our network. |