Risk Program
What is the RHCP Risk Program?
Resurrection Health Care Preferred (RHCP) is a managed care contracting organization that contracts with risk, or capitated, HMO plans. RHCP currently holds contracts with HMO Illinois, BlueAdvantage, Humana, and Family Health Network at all or some of its sites.
Who is eligible to join?
Physicians in good standing who serve on the medical staff at any of the following hospitals are eligible to apply to join one of RHCP's "pods," or divisions:
| Hospital | Pod/Division |
|---|---|
| Resurrection Medical Center | Resurrection Health Preferred |
| Saint Francis Hospital | Saint Francis Health Preferred |
| Saint Joseph Hospital | Saint Joseph Health Preferred |
| Saint Anthony Hospital | Saint Joseph Health Preferred |
| Saints Mary and Elizabeth Medical Center | Saints Mary and Elizabeth Health Preferred |
| Our Lady of the Resurrection Medical Center | Saints Mary and Elizabeth Health Preferred |
How does the Program work?
Primary care physicians are paid capitation for most services, with some services reimbursed on a fee-for-service basis. Specialists are paid fee-for-service. Fee-for-service payments are based on a Medicare-based fee schedule.
Additional Requirements:
- Desire to participate in and follow the requirements of HMO plans.
- Minimum malpractice limits of $1/$3 million.
- Board Certification/Board Eligibility.
- Electronic billing capability.
Physician Benefits
- Access to Patients. Over 61,000 HMO members are enrolled with an RHCP pod. Many HMO members in the Chicago market access their physician through an IPA or PHO and must receive care from participating physicians.
- Comprehensive Physician Network. RHCP has approximately 1,100 physicians representing a full range of specialties that offer comprehensive care for your patients.
- Recognition as a Market Force. Consolidation of physician membership allows payors to recognize the quality and significance of RHC-affiliated providers in the capitated HMO market.
- Physician Leadership. The RHCP Board and Committees include physician members who actively participate in its governance.
- Administration. RHCP provides state-of-the-art utilization management and electronic claims processing.
- No Buy-In Requirements or Risk of Investment Loss. Physicians are eligible to participate without being required to invest in the organization and risk capital calls or investment loss, as has happened with many IPAs and PHOs.
- Become part of a comprehensive physician network. RHCP emphasizes providing high quality medical care to its patients.
- Professional marketing program. RHC's marketing program will work to increase physician practice volume.
For More Information
For more information call your Provider Relations Representative at Resurrection Health Care Preferred:
| Hospital | Contact | Phone |
|---|---|---|
| Saint Francis Hospital | Theresa Nichols | (773) 572-8289 |
| Resurrection Medical Center | Theresa Nichols | (773) 572-8289 |
| Saint Joseph Hospital | Tanisha Harvey | (773) 388-6139 |
| Saints Mary and Elizabeth Medical Center | Gabriel Ortiz | (773) 572-8319 |
| Our Lady of the Resurrection Medical Center | Gabriel Ortiz | (773) 572-8319 |
