CIN and ACO are two small acronyms for two very large concepts. In the health care industry, especially as it relates to Medicare payments, there is an increasing demand for a higher quality of care and lower costs. Those two ideas do not always play nicely. A single physician’s office would struggle to drastically reduce costs and upgrade care outcomes at the same time. As part of a larger group or network, however, the impossible becomes possible.
Joining a clinical integrated network (CIN) or accountable care organization (ACO) could help reduce the financial pressure of compliance. A CIN and an ACO have similar goals, though they are structured in different ways. This does not mean they are mutually exclusive, however. In fact, Advisory Board noted that a CIN often serves as the physician network arm of a larger ACO.
Read on to understand more about the differences between CINs and ACOs and how they can work together to improve health care.
What Is a CIN?
A clinical integrated network is a formal group of health care providers. By joining, providers collaborate to deliver more effective and affordable coordinated care and improve documentation, accountability and the patient experience. As a legal entity, a CIN grants the group a safe harbor against antitrust laws, letting them collectively negotiate for better payment rates with insurers
CINs often use shared electronic health record (EHR) systems, but not always. These systems let them track methods that offer the most value for the cost. They may also help physicians access learning opportunities and higher reimbursement rates.
What Is an ACO?
An ACO is another type of legal entity with similar goals to a CIN. It also uses technology to help connect participating providers as they aim to reach specific goals, primarily reducing costs and improving the quality of care.
ACOs are well-defined with specific requirements and goals. They cover the entire continuum of care and allow providers to share savings. If there is a difference between the cost of care and benchmark costs, the ACO can share those savings. They can also receive further benefits from payers in the form of bundled payment options and global risk.
CIN vs. ACO
The primary differences between ACOs and CINs lie in their structure and legal obligations. An ACO is more structured and must abide by specific rules. For example, an ACO covering Medicare patients must comply with the Centers for Medicare and Medicaid Services’ benchmarks and quality measurements. A CIN is a bit more flexible and does not require a formal legal structure, letting them adapt to organizational needs.
A CIN is often the platform upon which physicians can build an ACO. It can provide a legal framework around which physicians can set goals for standardization, efficiency and coordination. While an ACO can be intimidating for new or small organizations, CINs can be more accessible. They frequently serve as a precursor and companion to an ACO, helping organizations set the basis for meeting the ACO’s demands. CINs and ACOs can also help serve different populations, such as commercially insured patients and Medicare or Medicaid beneficiaries.
ACOs Are on the Rise
More and more organizations have begun to see the benefits of ACOs. As of January 2022, 483 ACOs were serving over 11 million Medicare beneficiaries. This growing popularity is partially due to the introduction of the Medicare Shared Savings Program, which provides powerful incentives for ACOs. Still, not all organizations are created equal.
Tracking and documentation are key to the success of an ACO. Using technology solutions such as big data analytics and EMR reporting systems, ACO members can keep a pulse on the success of the program and make adjustments as needed. ACOs that fail this due diligence may have to drop out of the MSSP.
CINs and ACOs complement each other. With proper technical support, these types of organizations stand to win big by improving their quality of care, lowering costs for patients and getting better payment rates from insurers.
Implementing the Right Tools for a CIN or ACO
If either option sounds right for your practice, the appropriate technology will help you set yourself up for success.
Happe-Analytics is a powerful resource for CINs and ACOs to simplify reporting and analysis. It connects to your EHR, pulling specified criteria to understand your progress toward CIN goals or ACO reporting requirements.
At Tangible, we can make CINs and ACOs more attainable through easy access to technology that connects data across organizations and locations. Reach out to us today to learn more about how Tangible Solutions and Happe-Analytics can help you ease data management and focus on patient care.