PHPprime Primary Care Providers and Preferred Specialists are expected to use the MCS Essette Prior Authorization Portal to submit pre-certifications, referrals and prior authorization requests. Request access to the portal here.
Independent. Quality. Coordinated Care.
PHPprime is an Independent Practice Association (IPA) with more than 300 primary care physicians and advanced practice providers. Driven by our strong commitment to high quality and coordinated care, PHPprime is a clinically integrated group sharing four commercial Accountable Care Organization (ACO) contracts and one exclusive Medicare Advantage contract.
- Mostly made up of independently owned practices
- Contracted with four major health insurance plans in ACO contracts and one exclusive Medicare Advantage contract – contracts vary in capitated risk, shared savings, increased RBRVS, care coordination payments, etc.
- Participating in the Medicare Shared Savings Program (MSSP)
- Able to refer to all hospital systems
- Focused on a coordinated, team-based care coordination approach
- Committed to providing patient- and family-centered care
- Accountable for achieving positive performance outcomes and shared savings opportunities
PHPprime practices receive support from Physician Health Partners, a management services organization with more than 23 years of experience working with primary care practices. With the established infrastructure from Physician Health Partners, PHPprime practices receive tailored solutions to help them navigate through the managed care, ACO, Centers for Medicare and Medicaid Services (CMS) and insurer requirements.
Physician Health Partners is on the forefront of innovation, providing support to practices with programs such as the Merit-based Incentive Payment System (MIPS), Comprehensive Primary Care Plus (CPC+), State Innovation Model (SIM), Primary Care First (PCF) and more. Physician Health Partners provides services at no out-of-pocket cost to our practices. Their team of expert nurses, social workers, population health specialists, care coordinators, certified professional coders, quality improvement coaches, data analysts, EHR specialists and other health care professionals work with PHPprime practices to provide: