There is a trend in the local and national health care markets towards value-based contracting. This requires a focus on improving a practice’s quality score and reducing the cost of care.
Clinically integrated networks (CINs) are integrated systems of physicians, hospitals, and other medical facilities that collaborate to improve quality, patient satisfaction and efficiency of care. The structure of these physician-driven networks encourages a team-based approach to care delivery, allows for greater sharing of patient data and best practices, and encourages adherence to evidence-based medicine.
One goal for a CIN is to develop a continuum of care network that can influence quality outcomes and the efficiency of care provided. This network provides physicians an opportunity to improve their own value-based performance through a sharing of clinical data, education and care coordination activities.
Physicians can benefit by having the CIN handle most annual requirements relating to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The only provision the physician is still responsible for is the Advancing Care Information performance category.
Most payers prefer a CIN to be a multi-specialty network. This provides specialists an opportunity to participate in adding and/or protecting their primary care referral sources. In addition, CINs are looking at ways for specialists to participate in shared savings (i.e. episodes of care that are targeted at the specialists in a network).
Physicians can improve access to care by sharing after-hour clinics and urgent-care centers in the CIN. Practices are also encouraged to have evening and weekend hours available to patients. This includes the ability to leverage non-physician providers to handle the additional volume of patients.
CINs help physicians move from volume to value-based contracts by providing the necessary infrastructure. This includes clinical leadership, care management support, IT services, and governance in order to better manage patient demand and improve patient satisfaction and clinical outcomes.