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Assessing the Structure and Operations of a Clinically Integrated Network

Client/Profile

A midwestern academic medical center health system that participates in a CIN jointly owned by hospitals in and beyond the health system.

Challenge/Situation

To assess the governance and operations of the CIN to determine an optimum ownership and operating relationship between the system and CIN.

Process

We worked with a small working group of top health system leadership plus the CEO of the CIN.

Veralon conducted interviews with the CEOs of each of the member hospitals; and with system leaders in quality of care, IT, finance, and legal affairs; as well as with the leadership team (including board members) of the CIN.

We conducted an assessment of operations and strategic position, focusing on five categories: governance structure, membership and network, IT and analytics, payer contracting, and quality and care management. For each of these Veralon used interviews, data review, and industry best practices to determine current status, ideal future state, and the difference between the two.

We provided the client with two alternative structural options for moving forward, and looked at the degree to which each would enable achievement of the ideal future state. In the process of analyzing the alternative structural options, Veralon examined other CINs at both academic medical center and community hospital systems across the country. We interviewed representatives, created profiles, and described the process of how each CIN arrived at their current structure and what that experience had been like.

Results

After Veralon’s analysis was concluded, health system leadership had concerns about legal issues related to the options. They brought in a legal team to assess those issues, and that work is in progress.