FIVE TAKEAWAYS

CLINICAL INTEGRATION STRATEGIES TO DRIVE VALUE-BASED PERFORMANCE

Amidst the uncertainty surrounding healthcare, one thing remains clear: hospitals and health systems will continue to face increasing financial and quality pressures. Discover how clinical integration is a proven method for improving value across the care continuum in today’s value-based environment.

These five takeaways were presented in a webinar on Mar. 8. The entire webinar can be accessed at ModernHealthcare.com/ClinicalIntegration.

Appropriately incentivize physicians to drive clinical performance

According to Navigant’s Dennis Butts, “Clinical integration should be a verb, not a noun, describing actions networks should implement to successfully transition to value.” An example of this: drive engagement and clinical performance by appropriately incentivizing physicians. For instance, GRIPA created an incentive payment methodology rewarding physicians who supported their ACO goals and met specific performance measures. 50-70% of the methodology was based on Quality Measures, 20-40% on Cost Savings Measures, and 10% on Good Citizen Measures.

Create contracting strategy to support CIN, meet needs of healthcare purchasers

A contracting strategy that’s aligned and effective can be customized to support the unique CIN clinical program and assume risk appropriate to network maturation. Successful networks build their programs to be market driven, and focused on areas that payers and employers find valuable from a cost and quality perspective. This approach enhances the likelihood of monetizing the clinical program and addresses areas of opportunity that are meaningful to the market, and clinically relevant.

Build a successful physician engagement culture across specialties

To drive a successful clinically integrated network (CIN), bring together physicians across all specialties. According to Mark Shields, M.D., retired Sr. Medical Director of Advocate Physician Partners and current Sr. Advisor at Navigant, culture is the primary driver of clinical integration, and there’s 5 key aspects to building one that promotes high engagement. Physicians must have a sense of togetherness, be market driven, be cost effective, and operate under a physician driven/professionally managed system that promotes team-based care.

Create an infrastructure to support physician performance

A strong clinical integration program identifies clinical priorities and articulates how the network will support providers to hit metrics required to generate value. This support should come from care managers, practice coaches, analytic experts, and performance improvement personnel. According to Joseph Vasile, M.D., President/CEO of Greater Rochester Independent Practice Association (GRIPA), physicians are more inclined to be actively engaged when the network enables their success, due to the infrastructure put in place and coaching to advance best practices organization-wide.

Make sure data is useful to physicians.

Provide physicians with actionable information that delivers meaningful reporting - not just measures for measures-sake. This increases measures buy-in and eliminates pushback for deficiencies in the numbers. Structure data to allow for rapid response to custom requests, and provide scorecards geared to administration and diverse care sites. Matt Husmman, Director of Population & Practice Management Analytics at Henry Ford Health System, suggests this helps ensure data resonates with physicians, and provides simpler, easy to read information.