Clinically Integrated Networks (CINs) Lead to Better Healthcare
Population health management is like a jigsaw puzzle. All the pieces have to fit just right for medical facilities to achieve — and patients to receive — high-quality care. An unbroken continuum of care is no ordinary task, especially when there are many working parts, including insurers, private healthcare managers, assisted living facilities, pharmacies and reference labs, and clinicians.
While there are many ways for healthcare providers to come together and collaborate for improved continuity of care, a clinically integrated network, or CIN, provides a wide range of benefits above and beyond loosely associated practices or referral networks. With a CIN, a legal framework is put in place that can be leveraged to both improve patient care and increase revenues.
What is a Clinically Integrated Network
In an era of value-based patient care and outcome reports, including value-based reimbursement and other Pay-for-Performance programs like MIPS (Merit-based Incentive Payment System), a clinically integrated network enables all healthcare providers and physician members involved to share data seamlessly with one another.
A CIN provides a framework within which doctors and other healthcare providers can facilitate greater coordination, care delivery and understanding from provider to patient, group to health information exchange (HIE), health plan payers to medical office or hospital, or employer-based network to clinician.
The key driver of a CIN is data. Accurate, up-to-date, accessible and continually refined data records are what makes it possible to coordinate care across multiple organizations and locations, from primary care physician to specialist, from hospital to laboratory, from insurer to health exchange, and from pharmacy to patient. Every piece of data and every process is part of the larger puzzle.
Tangible Solutions establishes the technological aspects that can help you create a fully connected medical community, so your clinical integration can send and receive patient data reliably, securely and efficiently. A CIN that has been created and managed correctly allows independent physicians and groups alike to reduce the cost of patient care and improve outcomes, allowing all associated members to benefit.
What Are The Core Features of CINs
Each patient population has its own unique health needs and circumstances that impact well-being. Similarly, clinically integrated networks are wide-ranging: the clinical groups in one CIN may be quite different from the next, with hundreds now up and running, including those that form the legal framework of an Accountable Care Organization (ACO).
At Tangible Solutions, we are cognizant of the fact that CINs are comprised of a variety of healthcare professionals. But we also know that for each employed physician to deliver value-driven care, truly effective CINs share some key characteristics:
Even though the core functions of a radiological group may differ from a lab, all the physicians who participate within a CIN must be willing participants to ensure trust, transparency and continuity. This requires physician leaders to be goal-driven and laser-focused on enhancing care coordination and data delivery. Tangible Solutions can make engagement — a key component of physician leadership — easier by increasing efficiency. This is made possible by the facilitation of accurate data across the healthcare ecosystem.
Value-based care in the age of MIPS/MACRA requires clinical groups to hold themselves — and their fellow CIN participants — accountable. Once member physicians agree to participate in a clinically integrated network, they must abide by the rules and regulations laid out in the agreement. At Tangible, we specialize in information management so CIN participants can leverage the tools they need to hold themselves and their fellow CIN members accountable.
Evidence and value-based care
With MIPS rules now in effect and more groups participating in the merit-based program with each passing year, the “bones” are in place for how participants can assess whether they’re actually delivering a better standard of care. Putting the meat on those bones is up to care managers. CINs and CIN members must work together to drive better health outcomes for patient populations.
Whether that’s through the enforcement of compliance protocols, physician reimbursements or enhanced oversight, truly effective CINs adhere to quality measures that drive performance and enhance patient satisfaction across the healthcare system.
Tangible Solutions specializes in MIPS reporting. With our proprietary Happe-Analytics reporting tool, groups can collect the data they need to improve workflows, enhance coordinated care and maximize process improvements wherever weaknesses may exist.
High-performing CINs are always proactive, not reactive. That goes for care design, administrative optimization or leveraging technology to reduce wait times. Tangible can serve as your partner in driving patient engagement through custom technology solutions and electronic medical record sharing. This way, care managers can review medical histories prior to patients’ arrival, which reduces wait times and reinforces forward-focused healthcare delivery.
The Many Benefits of CINS
Healthcare organization and participating physicians gain a variety of advantages from being part of a CIN.
Duplicate procedures drain assets, waste resources and sap energy. Much of this can be prevented by better coordination, collaboration and — perhaps most importantly — communication. Through optimized IT infrastructure that Tangible Solutions can install, CINs can reduce the cost of care both for patients as well as participating healthcare providers. This is made possible by sharing data so physicians and care managers can connect with their colleagues.
Improve reimbursement rates
When patients are more engaged in their ongoing health and well-being, they’re more likely to have fewer illnesses and live longer. Since CINs are proven to provide better care — thus improving patient outcomes — high-quality care can yield better reimbursement rates, which is the upshot of MIPS reporting. Tangible Solutions has the experience and capability to streamline data sharing so better coordination can yield more reimbursements and provide a way to negotiate better contracts with payors.
Tightened community connections
No matter how diverse your CIN happens to be or where member participants are located, a CIN supports stronger community connections. Through Integration-as-a-Service, we’ll help you build a foundation customized to your unique needs and tech capabilities, as well as those of your community member colleagues (e.g. labs, rehab facilities, nursing homes, etc.)
Improved quality outcomes
With programs like MIPS building on the concept of continual healthcare improvement, a way to maintain a steady upward trajectory of performance improvement in care management and patient outcomes is required.
Developing a CIN creates a way for providers with an independent practice association, as well as larger healthcare organizations, to pool knowledge, talent and health data to deliver better preventive care and more consistent patient outcomes.
When a CIN is properly supported by technology, workflows and patient care improve, resulting in the following benefits:
- Empower personnel to address tasks that require accurate data across multiple sources
- Increase EHR access without compromising security
- Maintain independence for a primary care physician or specialist
- Adapt to and learn from changing payment models
- Collaborate with colleagues to streamline healthcare delivery
- Improve interoperability and create better datasets
- Increase growth by incentivizing process improvements
- Reduce administrative stress and expenses
Why partner with Tangible Solutions
No matter where your group falls within the healthcare continuum, you have plenty on your plate. And while CINs improve efficiency across a committed organization, the steps involved in setting one up just add to your to-do list.
We can also make it easier to coordinate with other healthcare providers who may be involved in care delivery. In doing so, you can work in partnership to avoid gaps of care and at the same time reduce unnecessary procedures, which can help reduce the cost of care and improve the patient experience.