Clinical Integration: Implementation and Optimization
Clinical integration is gaining traction. More hospitals and health systems are establishing Clinically Integrated Networks to prepare for value-based payment and to engage their physicians. But creating the structure is just the first step in truly achieving clinical integration, a goal that requires a significant shift in how patient care is provided and organized.
Veralon can support your organization in achieving clinical integration, resulting in a positive impact on patient care.
If you are a healthcare attorney, you may be interested in “Clinically Integrated Networks and Contracts with Commercial Payers: The New Frontier.”
Veralon’s support for clinical integration implementation or optimization can include any or all of the following.
- Facilitating intensive physician engagement of both employed and independent physicians
- Choosing a manageable number of clinical care initiatives to pursue within available infrastructure and resources—setting priorities for types of patients and care settings, and defining approaches to care (e.g., patient centered medical home, chronic care management systems, clinical guideline development)
- Leading the process of clinical guideline development
- Creating data services to provide the timely and consistent data that CINs need to support quality monitoring and provider accountability, serve as a basis for quality incentives and rewards, and support sharing of patient information among those caring for the patient
- Developing care management programs customized to match specific organizational characteristics
- Identifying quality monitoring goals and specific metrics
- Engaging primary care physicians to transform their approach to practice
- Establishing a budget and capital plan
In addition to engaging physicians, clinical integration is part of a broader strategy for value-based payment and alignment with payers. Veralon can work with legal counsel to determine whether clinical integration will meet the standards of the Federal Trade Commission (FTC) and what the implications are for payer contracting.