As healthcare continues its shift from fee-for-service to value-based care, providers have been looking for ways to partner with other entities in order to keep up with the changing landscape. For small medical practices facing significant pressure, the promise of reaching economies of scale is driving them to look at options like Clinically Integrated Networks, or CINs.A CIN is typically defined as a health network working together to improve patient care while lowering costs and increasing value to the community. CINs are an expanded approach to the classic independent physician associations (IPA) model and allow physicians to band together to work with health systems and payors while still maintaining their own practices. The solution is attractive to providers seeking to maintain their independence and autonomy, and allows them to maximize efficiencies while increasing provider-to-provider collaboration across participants. According to the Advisory Board, total CINs in the U.S. jumped from five to more than 500 between 2008 and 2012.
CINs live at the intersection of quality improvement and cost reduction. Usually comprised of a variety of PCPs, specialists and other providers, CINs help small-practice providers reach economies of scale and provide a variety of benefits that help facilitate care coordination across the continuum.
More Data for Better Quality
By pooling data, CINs offer providers a unique advantage to the quality, efficiency and efficacy of care. Aggregating the numbers from a larger spread of providers allows physicians to dive into metrics to find high-utilizers, identify costly readmissions, and solve unmet social needs, to name a few.
KentuckyOne Health Partners, a CIN in the Catholic Health Initiatives family, provides its physicians with a care management system that collects data and allows them to improve quality through predictive modeling, risk stratification, and evidence-based protocols.
By demonstrating their quality improvement as a group, the physicians have achieved better reimbursement rates from payors than when they were on their own. And with increased availability of both patient-reported and real-time data, the opportunities for quality improvement and additional savings among all networks and systems will only increase.
More Resources for Better Care
Shared data in CINs sheds light on areas for quality improvement, but it also provides opportunities for doctors to share resources to fix them. CINs make it easier for doctors to collaborate on case management, gain input and discuss care plans, and obtain direct access to other clinicians for patient referrals and second opinions.
Additionally, CINs are able to leverage their strength in numbers to collectively bargain for external services that are too expensive or inefficient for smaller practices. Just this year, Atrius Health, a nonprofit physician-led organization, entered into an agreement with IBM Watson Health to bring artificial intelligence to the doctors in its network. With this human-like robot tool, Atrius hopes to help its physicians deliver more personalized care.
On the Horizon
The rise of CINs, and the collaboration between health systems and providers, points to the value of true care coordination. Organizations that once competed are now realizing that their goals are more aligned than they thought. In Detroit, Beaumont Care Partners, a CIN, was formed from the combination of a local hospital and health system, accountable care organization (ACO), and IPA.
Alliances like these combine scaled health services, a population health focus and the management to provide more comprehensive patient care. And, as the healthcare industry continues to focus on patient-centered, data-driven, and outcome-focused care, clinically integrated networks will continue to provide models for care coordination.