Questions and Answers

What is TPHO?

The TriHealth Physician Hospital Organization (TPHO) is a clinically integrated organization committed to surprisingly human care. Within TPHO are employed and independent physicians. These members participate in joint hospital and physician contracting and align economic incentives for improvements. With access to physicians across the full spectrum of care, our large and easy-to-access TPHO network provides common care management models and shared information infrastructure to deliver on the triple aim of better care, better health, and better value for every patient we serve. Through value add and patient centered solutions, TPHO manages financial and performance risk leading to better health and higher quality of life for our community.

1. What is the importance of clinical integration?

Clinical integration is required to coordinate a full spectrum of care for the patient – from birth through old age. Everyday TPHO strives to give a more personal, connected experience to help patients – regardless of their unique challenges or needs – the ability to achieve their best health.

2. What are the advantages of clinical integration to TPHO members?

Clinical integration provides a way for participating hospitals and physicians to manage population health and better coordinate care across the full continuum. It drives high-quality, cost-effective care and allows participating physicians to align economic incentives for improvements in cost, quality, and efficiency for the evolving reimbursement models.

3. Who are the participating hospitals?

Good Samaritan Hospital
Bethesda North Hospital
Bethesda Butler Hospital
McCullough-Hyde Memorial Hospital
TriHealth Rehabilitation Hospital

4. As a member of TPHO, which contracts are available to me? Do I have to participate in all of them?

TPHO plans to execute fee-for-service, surplus sharing and risk-based contracts with commercial and government payers and make those contracts available to its members. Each member can then choose which contracts they participate in. Members will not be required to participate in a minimum number of contracts, and those who choose to opt out of a payor/TPHO contract are not prohibited from entering a direct contract with that same payor.

5. As a member of the TPHO can I participate in other ACOs/PHOs/IPAs?

Primary Care providers who become TPHO members may not participate in another competing ACO/PHO/IPA.

Specialists may participate in other ACOs/PHOs/IPAs individually or through a group practice.

6. Can I refer to any physician, facility, or other provider within any health system?

Continuity of care is one of the most important reasons we are successful in TPHO. To realize the benefits of being a clinically integrated organization, providers must refer patients only to other participating providers with few exceptions: patient preference, payor requirements, provider judgment.

7. How do I confirm the contracts I participate in through TPHO?

Any questions related to the TPHO value-based contracts can be directed to TPHOProviders@TriHealth.com.

8. Can I admit to participating hospitals?

Yes, if you have appropriate medical staff privileges.

9. Is there a cost to join or maintain membership in the TPHO?

There is no cost to join TPHO and no annual dues. TPHO may retain a portion of future earnings prior to distribution to help offset operating cost and expenses and establish reasonable reserves.