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A clinical integrated network, or CIN, can provide substantial value to a specialty practice or other healthcare provider group. When you fully leverage the capabilities of a CIN, you can achieve higher standards of patient care, and maximize earnings by qualifying for incentives that increase your year-end revenues.
Find out how establishing and maintaining a CIN can benefit your practice.
What is a Clinical Integrated Network (CIN)?
A CIN is a legal structure designed to support and manage collaboration among health care providers. CINs help providers promote better coordinated and higher-quality care at an improved cost level that aims to achieve maximum reimbursements.
Private and employed physician practices can form CINs. The three accepted types of CINs are:
- Joint Venture Physician-Hospital Organization (PHO)
- Health System Subsidiary
- Independent Physician Association
No matter the structure of a CIN, it must have physician leadership at governance level. All CIN members must commit to clinical guideline compliance and participation in activities to improve performance across the spectrum of care, including:
- Treatment quality
- Accuracy in diagnostics and billing
- Efficiency and timeliness of care
- Patient outcomes and satisfaction
CINs must show improved value, not just leverage collective power for negotiating reimbursement rates. The expectation is that CINs will use technology and tools, including electronic health records (EHRs) to identify performance objective goals and prove their achievement.
A CIN can also provide a platform to support an accountable care organization (ACO). This allows practices and groups to pursue Pay-for-Performance incentives for value-based care based on diligent, ongoing outcome reporting.
Goals of Clinical Integrated Networks
The four goals of a CIN are:
A CIN should engage both providers within the network, as part of the requirement for such organizations to being physician led. Without physician commitment and participation, a CIN cannot fulfill its legal obligations as an entity, invalidating its worth. CINs should empower providers to enhance their levels of patient care and drive improvement across reporting of measured metrics to reach predetermined goals.
CINs can significantly improve accountability across a group of providers or practices, helping to set expectations for participation and identifying when expectations are not being met. Since it could individually impact negatively on physicians for failing to take part, there is incentive to be accountable.
The value of care provided is a key point for CINs. If the group does not prove extra value through meticulous record-keeping, measurable advances, and data analytics, the CIN cannot be used to leverage higher reimbursement rates. Since improving the value of care relies on reducing costs of care (as in preventive action can minimize ongoing care costs for populations at risk for chronic illness), there is a clear incentive for continued improvement in value across the board.
A CIN doesn’t work unless physicians take the lead and are proactive in their choices for data tracking and practice improvement. One way CINs can succeed is by working with a technology partner who can integrate their EHR with reporting tools for maximized incentives and clearer measurement of key metrics.
Benefits of Clinical Integrated Networks
The core benefits of a CIN are all connected to each other. Achievement of one goal leads to related benefits, which helps achieve the next goal, leading to additional benefits.
A CIN can bring all of your physicians together to achieve common goals, improving proactive leadership and accountability. Getting on the same page in regarding EHR use, diagnostic and billing codes, and consistent chart maintenance improves practice workflows and delivers superior reporting and improved patient care. Better communication and networking within the community (with labs, nursing homes and other care-related facilities and providers) can also improve by leveraging a CIN.
Improved patient care
Better patient care leads to positive patient outcomes, including reduced risk of re-admittance after surgery, lower incidence of comorbidities, and higher prevention rates for common illnesses and chronic diseases. By delivering the best possible care at each touch point, it avoids complications and more expensive remedial care, leading to lower costs. Better patient care also leads to better patient satisfaction, increasing word-of-mouth referrals and improving the life-time value (LTV) of individual patients.
Lower costs help qualify practices and physicians for incentives based on Pay-for-Performance programs. Decreased costs have the added advantage of improving value across the CIN. Lower costs are one of the key metrics used in calculating incentive based revenue adjustments, leading to higher reimbursements.
Besides the ability to negotiate reimbursements across the board, a CIN that leverages reporting for the Merit-based Incentive Payment System (MIPS) can improve MIPS scores. High-level reporting and proof of year-over-year performance improvement can help qualify groups, practices, and individual physicians who provide Medicare Part B services for higher incentive bonuses at the end of each year.
Why partner with Tangible Solutions
At Tangible, our specialists can help guide you through your CIN data connection setup. A properly established and maintained CIN should foster physician engagement, encourage full participation, drive high-level reporting and enhance coordination.
Tangible’s optimized IT infrastructure supports CINs in reducing the cost of care both for patients and participating healthcare providers, making it easier to share data and deliver clear, consistent data reporting that hits benchmarks for incentive-based programs. Our Happe-Analytics solution handles reporting year-round, providing you with the tools and support to maximize incentive payments from any value-based program.
Your CIN can benefit from an infrastructure designed to streamline workflows, improve patient and community connectivity and engagement, and empower compliance with rigorous reporting and scoring requirements for the highest possible reimbursements and bonuses. By integrating your CIN with modern technology, you can fully leverage your EHR.
Are you ready to establish a CIN to deliver better patient care and outcomes while giving yourself the leverage to achieve maximized revenues? Contact Tangible Solutions today to discuss how we can help set your CIN up for success.