With the healthcare industry gradually moving toward a value-based payment system, many healthcare networks are reorganizing to improve patient care and reduce operating costs.
One way hospitals and independent physicians are improving quality and efficiency is by forming clinically integrated networks. Joe Lupica, chairman of Denver-based Newpoint Healthcare Consulting and Ninfa Saunders, DHA, president and CEO of Macon, Ga.-based Navicent Health, recently spoke with Becker's Hospital Review about the benefits of joining a clinically integrated network.
Here are three key points shared by Mr. Lupica and Dr. Saunders.
1. Participating providers can still maintain their independence. A clinically integrated network consists of a number of physicians, hospitals and post-acute care providers that align around shared risk and protocols to improve quality and reduce the cost of care. CINs have become increasingly popular in recent years because all three of these participating groups can maintain control over their practices or institutions, a feature often lost in a full merger, according to Mr. Lupica. "Providers simply participate in a CIN instead of handing over the ownership of their practices or hospitals to a controlling health system," Mr. Lupica says. For physicians, that independence allows them to create their own destiny, constructing their career based on their own personal needs, goals and career ambitions, according to Dr. Saunders.
2. CINs are prepared to adapt to changing payment methods. Mergers and acquisitions are sometimes more appealing to hospitals than CINs because they tend to provide hospitals with immediate access to capital, according to Mr. Lupica. "It's easier, sometimes, to get a bag of money, and the industry really pushes that [mentality]," he says. The innate structure of a CIN, however, is geared toward optimizing processes and approaches that result in the best possible care available to patients. A clinically integrated network "focuses on the use metrics, structure and processes ingrained in the group's ethics and ideals to discover the best way to treat and care for patients," says Dr. Saunders. Because CINs are not as concerned with profit margins or market competition as other types of healthcare organizations, CINs are prepared to adapt to changing payment models in the healthcare industry.
3. Standing like a rock is no longer viable. Because of the changes taking place in the industry, hospitals and health systems that choose to, like Simon & Garfunkel, stand as a rock or island won't be able to sustain themselves in the end, according to Mr. Lupica. Instead of clinging to a notion of complete independence, "hospitals can move toward interdependence without selling or merging and CINs offer a splendidly balanced way to do that," he says. The idea of interdependence must also reside in the ethos of a clinically integrated network, otherwise, the organization will crumble, according to Dr. Saunders. Successful CINs operate on a pluralistic approach — multiple components must exist and work together for the organization flourish. Those components, whether it be individual physicians working side by side or physicians and hospitals coming together, must "operate in a dyad," says Dr. Saunders. "Physicians and hospital[s] alone won't work. Nothing will work as well as both members [meeting] in the middle to craft a solution together," she says.