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FAQ
What is Clinical Integration?
In today’s healthcare environment, many systems, providers, and payers are joining forces to help improve the delivery and quality of care and create greater value for patients, providers, payers, and communities.
Clinical Integration is a physician-led and patient-centered approach to healthcare management and coordination. It brings together hospitals, health systems, physicians, government payers, and commercial payers through shared data, technology, and performance benchmarks to deliver higher quality – and more affordable – care. This integration is deemed sufficient by the FTC to allow the Clinically Integrated Network to jointly contract with payers and hospitals to create and share in the “value” created through their dedication to delivering high-quality care and their commitment to enhancing the patient experience, improving quality, and reducing costs.
What Are the FTC Requirements for Clinical Integration?
- Selective Physician Partnerships - A network of physicians opting to collaborate in delivering evidence-based care and improving quality, efficiency, and coordination of care;
- Comprehensive Improvement Initiatives - Identified and evolving metrics designed to meaningfully impact clinical practice of all physicians in network to improve value across full continuum of care;
- Performance Improvement Architecture - Data-driven mechanisms and processes to monitor physician performance as well as manage utilization of health care services, to ensure quality of care and control costs.
What Are the Benefits to Participating Physicians?
- Stability, support, and resources of a large provider-centric network while remaining independent;
- The ability to collectively negotiate value-based contracts as a network with commercial health plans and self-funded employers;
- Access to staffing and technology resources to help improve quality and efficiency of care;
What Are the Benefits to Health Systems?
Physician alignment and engagement will be key parts of the continued success of health systems. Offering to align with physicians through Clinical Integration is a strong way to get physicians involved with quality improvements, placed in leadership roles, and aligned around a consistent model of care.
Hospitals can work closely with physicians through the CIN to improve acute care performance through legally structured arrangements to share in savings around quality and efficiency initiatives.
A strong CI program will become a market leader on quality and efficiency, and a single point of contact for payers and employers as a value-based partner. A hospital-sponsored CI Network can develop payer relationships with insurance plans to build robust care management and clinical programs that can serve broader populations throughout their market areas.
How Can I Join?
Contact us today to get more information about Concert, and see how you can fit into a leadership position in this initiative for a collaborative healthcare system.