In today’s health care landscape, organizations and individual physicians have many incentives to provide better care at lower costs. With the introduction of the Medicare Access and CHIP Reauthorization Act, the industry as a whole has had to make structural adjustments in regard to finances, care practices, technology and administrative tasks. Although the Centers for Medicare and Medicaid have provided months of ramp-up time for organizations to comply with MACRA, the process has been slow going.
In this changing environment, practices need something to help them get an advantage. After all, providing better services at lower costs isn’t an easy task. This is where the concept of a clinically integrated network can save the day.
What is a clinically integrated network?
At its core, a CIN is a collective of health care organizations in a local or geographic region in which providers share access to electronic health record systems. This network of systems allows practices to track shared patient populations in order to improve patient engagement and deliver the best care at the lowest cost. The main goals of a CIN are to increase efficiency and provide better care.
“A CIN helps practices deliver better care at lower costs.”
These advantages are achieved through joint efforts between practices to improve IT infrastructure and via collective bargaining, as sanctioned by the Federal Trade Commission. According to The Advisory Board, this type of collective bargaining is given a safe harbor by the FTC, making it possible for physicians to gain greater leverage when negotiating with insurers for better payment rates. The reasoning is that, because CINs can provide better care – and thus have fewer cases of patient readmittance – they qualify for better rates.
“The legal structure allows them to provide more integrated and coordinated care and do some more bargaining with payers, which would not be allowed from independent providers,” Senior Associate of the American College of Physicians Neil Kirschner told the ModernMedicine Network.
How practices benefit from clinically integrated networks
Independent practices can win big by joining a CIN. For physicians who purposely avoid employment by a hospital network, a CIN gives them a financial and practical advantage without giving up control over their practice. Patients win as well, because they can receive higher-quality care at lower costs from doctors they know and trust.
The added benefits of sophisticated technology solutions can give physicians greater insight into patient populations, regional registries, financial activities and advanced care options. Using integrated EHR systems, practices can easily share information such as lab orders and results, charge capture for billing, demographic data, scheduling data and continuity of care documents, among others. The result: better physician engagement. This enhanced communication means practices cut down on the resources they spend on administrative tasks, freeing up personnel to spend more face time with patients.
Clinically integrated networks provide a legal way for independent practices to bargain with insurers for better payment rates, make IT improvements that would otherwise prove difficult to implement on their own and help patients receive the best care possible. CINs are a legal structure with benefits that extend beyond the bottom line.