JeffCare

Jefferson's physician hospital organization (PHO)

JeffCare is Jefferson's physician hospital organization (PHO) focused on managed care activities of affiliated physicians and Thomas Jefferson University Hospitals (TJUH). JeffCare is a not-for-profit, taxable organization financed by the Hospital and annual dues from its individual physician members. As a member, you are now linked to the Jefferson Health System and are part of the TJUH JeffPlus employee benefit network of providers.

JeffCare's 930 physician members represent Jefferson University Physicians, volunteer faculty physicians as well as community physicians who may not have admitting privileges at TJUH hospitals. Roughly 300 providers are primary care physicians serving PA and NJ.

JeffCare's Core Services

• Managed Care Contracting – JeffCare uses a Messenger Model to contract with various payors on behalf of its physician members. Regular surveys of each physician group are conducted regarding minimum rate thresholds for each type of managed care plan. JeffCare works with the managed care payors to obtain rates acceptable to our members. Contract language is reviewed and each plan's provider manual is evaluated against JeffCare standards.
  
  Once an agreement is reached, JeffCare messengers the plan's rate offer to each physician group and requires a response for enrollment. JeffCare currently holds over 25 managed care contracts for primary and specialty physicians. Our staff also supports the Hospital contracting activities of the Jefferson Health System (JHS). Our focus allows coordination on special projects/opportunities such as transplant, new technology, and specialized programs for hospital and physician constituencies.

• Delegated Credentialing/Enrollment – Physicians are enrolled into all JeffCare contracted plans through delegated credentialing agreements. The delegated credentialing process meets the National Committee for Quality Assurance (NCQA) and the Joint Commission standards. Our staff monitors and manages all aspects of physician enrollment, including adds/changes/terminations, effective dates,provider numbers, accuracy of plan information
  
  
  Physicians are saved from having to complete regular credentialing applications with the various JeffCARE plans and only have to communicate updates of their practice information to JeffCARE one time. Updates are communicated regularly to the plans.
  
  
• Provider Relations and Outreach – JeffCAre serves as a liaison between payors and providers for resolution of issues and interpretation of plan contracts and provider manuals. Additionally, opportunities to link the community provider network to Jefferson specialty programs and services are actively pursued in support of building referral relationships among providers.
  
  Regular communication on managed care issues are provided through plan orientation sessions, email updates and a quarterly JeffCare newsletter and the JeffCare physician portal.
  
  
• JeffPlus Enrollment – JeffPlus is a benefit package offered to all employees within JHS. On behalf of members' full-time employees system-wide, JHS has worked carefully with Aetna US Healthcare and Independence Blue Cross to design a preferred benefit program that encourages employees to use JHS providers, facilities and other resources through discounted co-pays and deductibles. Because of these incentives, JHS employees are much more likely to select JeffPlus providers.
  
  JeffCare membership includes automatic enrollment in JeffPlus, insurance plan notification and inclusion in the JeffPlus Directory and website to inform JHS employees of your participation. For physicians, the total reimbursement is the same whether the physician is in JeffPlus or not.
  

    

Contact Information

If you would like more information on JeffCare, please email us at JeffCare@jeffersonhospital.org