Guided Access Primary Care

Cleveland Clinic is seeking board certified physicians to join our Department of Internal Medicine and Geriatrics or Department of Family Medicine in an exciting new role. We are seeking innovative physicians to help establish Guided Access Primary Care Clinics within each of our Northeast Ohio submarkets (east, west, south of Cleveland) to support optimized care for our highest risk patients in value-based contracts. Patients in scope for these specialized clinics are identified in partnership with our Value Based Operations team. Eligible patients (from value-based contracts) that demonstrate high utilization of healthcare services, are at greater risk of rapidly escalating medical needs, and/or are fragile and require more high‑touch management. This exciting opportunity focuses on building a team‑based practice to provide high‑touch primary care for a smaller panel of high‑risk patients. Model highlights include enhanced triage systems, integrated and expanded team, including embedded and centralized resources, extended appointments, collaboration with other enterprise partners (e.g. Medical Care at Home, Value Based Operations, etc.). These practices will use a fully integrated Epic electronic health record, and likewise be focused on quality improvement and innovation in care delivery. Team based care will include embedded Pharm Ds, Patient Navigators, Behavioral Health Social Work, Primary Care Social Work, Community Health Workers, and an RN Care Coordinator with strong Advanced Practitioner partnerships. Collaboration with our Geriatricians and other critical subspecialists will be prioritized to help ensure value‑based care to maximize quality, safety, and efficiency with reduced costs while delivering exceptional patient and team experience. Opportunities to explore interests in teaching and leadership can also be explored. #J-18808-Ljbffr Nejm