Frequently Asked Questions
The Overlake Provider Network (OPN) is a physician-led, formalized business association connecting independent physicians, employed physicians and Overlake Medical Center. Our business is measured by our patients' well-being. We develop and implement evidence-based, data-driven clinical initiatives to improve outcomes, increase efficiency and reduce costs in the inpatient and outpatient setting. The network began in July 2015 with over 20 independent and employed physicians.
Below are answers to frequently asked questions. Please do not hesitate to contact anyone listed at the bottom of the page if you seek additional information.
Who Will Lead OPN?
OPN operations and governance is physician driven, supported by an advisory team composed of executive support and physician leaders from all participating organizations. The 13-member OPN Board of Directors has independent primary care, employed primary care, independent specialty care, employed specialty care and Overlake executive leadership.
OPN Board of Directors:
Steve Marshall, MD, Chair, Emergency Department, Puget Sound Physicians
Allen Geltzer, MD, Vice Chair, Internal Medicine, Overlake Internal Medicine Associates
Jonathan Paley, MD, Obstetrics/Gynecology, Overlake OB/GYN
Kim Witkop, MD, Internal Medicine, Snoqualmie Valley Hospital
Denise Kraft, MD, Primary Care, Eastside Family Medicine Clinic
Pen Hou, MD, Primary Care, Redmond Family Medicine
Thomas Chi, MD, Orthopedics, Proliance Surgeons
Anne Bankson, MD, Primary Care, Overlake Medical Clinics Primary Care Hospital Campus
James Kriseman, MD, Primary Care, Overlake Medical Clinics Redmond
Thomas Amidon, MD, Cardiology, Overlake Medical Clinics Cardiology
Abhineet Chowdhary, MD, Neurosurgery, Overlake Neuroscience Institute
David Knoepfler, MD, Chief Medical Officer, Overlake Medical Center
Gary McLaughlin, Chief Financial Officer, Overlake Medical Center
How can physicians be involved in OPN?
Physicians may be involved in OPN through its committees. These committees and roles include:
Quality and Patient Experience Committee
- Develop and oversee the quality and efficiency of providers participating in OPN.
- Identify and implement new quality measures and policies.
- Develop and oversee the provider monitoring and remediation program.
- Develop and oversee the clinical management forums.
- Develop and oversee OPN’s disease management, utilization management and care management programs.
- Conduct root cause analysis on ambulatory, inpatient and post-acute quality performance and issues.
Network Development and Credentialing Committee
- Oversee OPN recruitment process.
- Develop and oversee participating provider OPN membership criteria.
- Develop and oversee OPN credentialing program.
- Identify areas of opportunity and network development for OPN.
- Collaborate with Overlake on value-added services identification and implementation.
Finance and Contracting Committee
- Develop, recommend, and implement OPN’s budget.
- Develop and oversee the incentives structure and program.
- Develop and recommend strategies for OPN payer contracting.
What are the costs to participate in the OPN?
There will be no up-front costs to join the network. Any future fee would be based on a fair market value assessment due to participants receiving significant value from the network.
If OPN is contracting on my behalf, what happens to my existing contracts?
You will maintain the direct contracts you have through your practice with all payers. The contracts negotiated by OPN are considered an “overlay” on those direct contracts and are designed around specific performance metrics to improve outcomes for a designated patient population. Your existing fee-for-service contracts would not be impacted. The OPN Board of Directors will decide if/when the network should negotiate fee schedules. The network would be notified if this takes place.
What happens if I do not sign up for OPN?
Since OPN will be involved in narrow networks and accountable care programs that require referrals to in-network physicians based on benefit design, there is potential disruption to referrals and access to lives. Due to some of these networks being narrow and requiring referrals to only in-network providers to ensure a member receive the highest benefit, OPN will look to refer to physicians who are part of OPN. With that said, members/patients will always have a choice, but may look to stay within a network to ensure they pay the least out-of-pocket.
What benefits does OPN provide
- Innovative contracts with payers and the potential for performance incentives.
- OPN offers the ability to remain in private practice.
- Access to resources such as population health management and access to useful quality and cost data; including accountable care network data collection/reporting needs.
- Value-added services:
- Group purchasing.
- More value-add services to come.
Will I have to pay for a Population Health Tool?
No, OPN would purchase the population health tool as a capital investment. Currently, OPN leadership is exploring the various technologies in the market and will make a determination based on multiple variables, including connectivity, compliance, user interface and cost. More value-add services to come.
For more information, please contact:
Brianna Kulman, Payor Provider Relations Coordinator
Justin Sampson, Director of Managed Care Payor Contracting
Richard Bryan, VP of Clinical Integration
Steve Marshall, MD – OPN Board of Director, Chair
Allen Geltzer, MD – OPN Board of Director, Vice Chair
Tom Amidon, MD – OPN Board of Director, Secretary/Treasurer