Our Physician Network is governed by an Advisory Board with appointees from both the network and UC San Diego Health.

Align health plans and establish risk-sharing arrangements.

Clinically integrate by securely sharing electronic medical record data.

Adhere to evidence-based guidelines that improve outcomes, prevent diseases, increase screenings and immunizations, and reduce unnecessary utilization and admissions.

Develop clinical programs to address the needs of high-risk patient populations and provide adequate access and availability to care.

Optimize processes that improve transitions of care and provider communication.

Consistently collect data, review quality and compliance scorecards, and improve performance.

Affiliation with the UC San Diego Health Physician Network offers the flexibility of partnership without requiring exclusivity or restricting your practice in any way. Your practice can leverage the benefits listed here simply by joining and adhering to our governing principles.

Our Independent Practice Association (IPA) is the cornerstone of our Physician Network. When you join, our patients will gain access to your practice as an in-network provider with our numerous commercial and senior (Medicare Advantage) HMO health plans.

By joining, your practice will become part of the highly ranked UC San Diego Health System. Our patients benefit from having more access to high-quality practices across southern California. We will work closely with your practice to employ multiple tools and strategies that streamline and optimize processes of care coordination.

As a member of our Physician Network, which is a Clinically Integrated Network (CIN), you will have contracting support to align your practice’s accepted health plans with our highly competitive PPO products and risk-sharing arrangements.

Participating in the Physician Network requires your practice to meet our quality and compliance standards, which we will review with you regularly on your affiliate scorecard. Our Quality Assurance and Performance Improvement team will conduct a site audit and work with you on any areas of improvement.

Clinical integration is a key element of affiliation. UC San Diego Health uses Epic EHR, and we offer affiliates a significantly discounted and customized version of Epic for their practice. Another option is a free, web-based tool called PHSO link, that can be used to read charts and notes, coordinate referrals, and communicate with other providers in the network.

Our affiliates can leverage many UC San Diego Health partners, including our group purchasing organization and patient experience survey provider. We also offer CME courses, resident and medical student placement, and resources to prevent provider burnout.

Affiliates in our network can grow their practice by being included in a multitude of the Physician Network’s sales and marketing channels:

• Inclusion in various directories, websites, maps, and promotional materials.
• Co-branded use of the UC San Diego Health Physician Network logo.
• Collaborative and networking events.
• Enrollment advertisements, insurance broker partnerships, and large employer relationships.

Providers must maintain an active, unrestricted medical license in the state of California, be board certified or board eligible in their specialty, and successfully complete CIN credentialing and recredentialing processes as scheduled.

To ensure alignment with our clinically integrated network and value-based care programs, membership in our network requires participation in the UCSD Health Network IPA. This affiliation supports coordinated care delivery, access to managed care contracts, and compliance with payer requirements.

Members are expected to actively participate in quality improvement activities, including attending meetings and trainings, collaborating on care coordination initiatives, and maintaining acceptable performance on the PHSO Scorecard. The scorecard reflects contractual requirements for quality and compliance established by insurance carriers. Affiliates must regularly review their scorecard results, meet performance standards, and work collaboratively with CIN leadership to address and improve any areas of underperformance.

Affiliates must use certified EHR technology (CEHRT) that meets CMS and ONC standards for structured data and interoperability. Alignment with UC San Diego Health systems is required; Epic is strongly preferred for optimal integration.

Affiliates are required to accept new patients and provide timely access to care as directed by federal and state agencies: primary care appointments within 10 business days, and specialty care appointments within 15 business days.

Affiliates participating in the network must bill insurances solely from practice locations within San Diego, Southwest Riverside, or Imperial counties.

In order to maintain a high-quality network and meet performance goals, clinical and administrative leaders are required to regularly participate in collaborative meetings and engage with network representatives.