Problem to Solve
A clinical integration network (CIN), sometimes called a clinically integrated network, is a vehicle for physicians to align more closely with health systems and adapt to new reimbursement trends that emphasize value-based payments.
Under the guidance of physician-led governance committees and review boards, a CIN is a specific type of legal arrangement enabling physicians and hospitals to collaborate on improving the quality and efficiency of care, while continuing to operate independently. In today’s era of value-based payment models, a CIN typically provides an efficient organizational structure for providers to reduce costs, maintain margins and more effectively manage utilization and population health. A CIN also allows participating physicians who are not ready for hospital employment a means of maintaining their independence.
Starting a CIN can be daunting due to countless legal and regulatory challenges unique to CINs, and the complications of adhering to a CIN’s myriad of quality-related requirements. That was the challenge faced by a large integrated health care system that sought to create a CIN to further develop value-based care programs and more specifically align with independent practitioners seeking a closer, value-oriented relationship. To develop and manage the CIN’s quality infrastructure, the health care system turned to Freed Associates (Freed) for assistance.
Strategy and Tactics
The CIN’s initial focus was on ambulatory care. Freed consultants worked closely with the organization’s director of ambulatory quality and patient safety, and primary care and specialty physician stakeholders, to identify and analyze evidence-based clinical guidelines and implement related quality measures. The project team’s work included:
Additionally, the team developed infrastructure tools for quality improvement and activities to support quality assessments. For example, developing a quality improvement (QI) resource compendium consisting of more than 130 QI and condition-specific on-line resources, as well as provider quick reference guides summarizing EMR documentation requirements for key quality measures.
The client implemented its CIN quality program as planned and on-schedule. The team’s work translated into analyzing more than three dozen prevalent population conditions, approving and adopting over 130 CIN quality measures across 10 specialties, driving CIN quality measure requirements documentation for Epic IT design and development, developing a scoring tool for annual measure review, and creating and implementing an internal CIN communications plan.
Providers increasingly must be accountable for delivering higher-quality care more efficiently and at a lower cost. By developing and implementing a top-tier CIN infrastructure, the health care system positioned itself to more readily achieve its quality, efficiency and cost-reduction goals and enhance its utilization and population health capabilities. Physicians participating in the new CIN can maintain their independence while also enjoying these same clinical and financial benefits.
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