FIVE TAKE­AWAYS

CLIN­I­CAL IN­TE­GRA­TION STRATE­GIES TO DRIVE VALUE-BASED PER­FOR­MANCE

Modern Healthcare - - THE WEEK AHEAD -

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.

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