Northeast Georgia Population Health Initiative

At Northeast Georgia Health System (NGHS), we participate in the Northeast Georgia Health Partners Network, which is a wholly-owned subsidiary of NGHS, in partnership with regional physicians and hospitals. Health Partners is a collaborative network that works to ensure patients have access to the highest quality and most cost-effective health care in Northeast Georgia.

Value-based care focuses on the quality and efficiency of care – leading to better outcomes. 

Health Partners focuses on population health delivery and value-based care, which have become increasingly important in recent years as more health systems and providers seek better ways to improve the health of the people and communities they serve. See the frequently asked questions below about these efforts and our affiliation with Health Partners.

What is population health?

Population health is an approach to health that promotes collaboration among all types of services and service providers (hospitals, physicians, community groups, etc.) that work together to deliver improved outcomes in the communities they serve. These partnerships work across the continuum of care, providing solutions to ensure people have seamless access to the right care at the right time and in the right place. In population health, providers focus on preventative measures, interventions, and incentives to promote health and wellness throughout the entire community.

What is value-based care?

Value-based care is a care model that focuses on the quality and efficiency of care and overall better outcomes. Providers prioritize the value of the care they deliver to patients, not simply the volume of patients they see, procedures they accomplish, or the speed at which they deliver care.  

Why are we moving to a value-based care model?

Value-based care encourages a team approach to patient care, and it’s a win-win for everyone. With providers working together to prioritize the health and wellness of their patients, patients are healthier and live healthier lifestyles, which results in healthier communities. Providers are rewarded for outcomes that are tied to measurable objectives based on quality and the improved health of the overall population.

How are we moving to this model?

Our affiliation with the Northeast Georgia Health Partners Network provides a foundation for providers to coordinate patient care that prioritizes value over volume. With more than 1,600 providers and advanced practice providers across a fourteen-county primary service area, Health Partners works to expand value-based services to ensure our health care is safer, more affordable, and more effective for the people and communities we serve.

What is a Clinically Integrated Network (CIN)?

A CIN is a collection of health care providers such as hospitals, physician groups, and others that collaborate to improve the quality of care and lower costs. CIN contracts with employers, payers, and other parties to deliver health care services to their employees or other covered individuals and the services are delivered by providers in the CIN.

What is HP2 and what is its relationship to NGHS?

HP2 is a physician-led CIN that was developed by the Northeast Georgia Health Partners Network. The HP2 network is a group of hospitals and more than 480 providers from dozens of practices across northeast Georgia that work together to better coordinate patient care. The network’s goal is focused on improving quality and outcomes while reducing costs for patients. Patients receive higher quality, more efficient care from like-minded providers who share data and information and follow consistent clinical programs and protocols.

What is the Northeast Georgia Health Partners ACO and what is its relationship to NGHS?

Various affiliated entities within NGHS participate in the Northeast Georgia Health Partners ACO, which fosters collaborative relationships throughout the entire continuum of care and brings greater benefit and value to the Medicare beneficiaries we serve. NGHS entities that participate in the Northeast Georgia Health Partners ACO can be found at Should Medicare assign you to the Northeast Georgia Health Partners ACO, you will receive notification from the ACO about what that means.

  • Dr. Antonio Rios, Chief of Population Health at Northeast Georgia Health System, was recently interviewed by Healthcare Innovation to discuss the health system’s work to improve access to care and quality of care for all populations of people.
  • Streamlined and improved processes—and patient outreach and education—closed care gaps for patients due for colorectal cancer screenings. Colorectal cancer is the third leading cause of death from cancer in the United States, mostly affecting adults ages 50 and older. The good news is that there are a variety of tests used to detect colorectal cancer, […]
  • Dr. Gibbs, a family medicine physician at Longstreet Clinic and population health leader in her practice and the community, recently shared a heartwarming story about her long-time patient Gerry Brown. During an annual physical, Dr. Gibbs noticed Gerry was a little late getting her annual mammogram and had a family history of breast cancer – Gerry […]
  • When we talk about Population Health, we’re addressing the health outcomes of a group of individuals in a population. These groups can be defined in many ways, including geography, ethnic groups, employment and access to healthcare. Our overarching goal is to understand the challenges each population subset faces and develop programs to help make a […]
  • In this short video, Northeast Georgia Physicians Group (NGPG) patient, JC Smith, discusses his patient journey under Dr. Antonio Rios, an Internist and Chief of Population Health at NGPG. JC has Type 2 diabetes, and managing his complex case, required a team care approach. Dr. Rios collaborated with Alix Schnibben, PharmD, BCACP, CTTS, Director of […]
  • While working as an embedded care manager within a primary care clinic, Ellen Woody, RN, met Mr. Gordon Harder, a patient with Type 2 Diabetes who struggled to control his blood sugar. Despite the doctor’s recommendation to take insulin, Mr. Harder refused. Ellen urged him to follow the doctor’s recommendation, but he was adamant that […]