Creating a Clinically Integrated Network

With the rapid transition to value-based care models, many healthcare networks are reorganizing into Clinically Integrated Networks in order to improve patient care while reducing operating cost and redundancy. Clinically Integrated Networks include the development of a team of primary care and specialty physicians to actively participate in a streamlined care delivery model.

Collective bargaining by physicians that compete with each other is considered anticompetitive and is prohibited except when physician networks are: financially or clinically integrated. In a clinically integrated network, employed and affiliated physicians can negotiate collectively with payers on reimbursement arrangements. It is a key step for networks, though a Medicare Shared Savings Program (MSSP), Accountable Care Organizations (ACO) are exempt from these requirements.

A Clinically Integrated Network must generally:

  • Show that they improve quality and efficiency
  • Deploy consistent clinical protocols across the network with the goal of achieving measurable targets
  • Monitor physician and network performance
  • Have a collective financial investment in a reporting system

By combining several small care systems into one larger, integrated network, healthcare providers can greatly increase the efficiency and quality of the care they offer. Sharing patient clinical and financial data across the network creates a more holistic view of the patient than is possible in a more "siloed" and traditional fee-for-service model.

To succeed as a Clinically Integrated Network, every healthcare provider in the system must have access to patient information through tools that are easy to use and allow for quality measurement across the network. Learn how Relay Health’s Enterprise Health Information Exchange can act as a secure, centralized repository for clinical data at your organization.

Next: Coordinated care across a population