Clinically Integrated Network Development

Clinically Integrated Network Development

Developing a Clinically Integrated Network allows a health system or hospital and its medical staff to collaborate on initiatives such as clinical care transformation, value-based payment, and accountable care. A CIN can be the best vehicle for aligning independent and employed physicians with a hospital or health system, and meeting the challenges of the transformation required by today’s environment.

Veralon has a high success rate in engaging independent physicians with healthcare organizations, and creating physician-hospital entities, including Clinically Integrated Networks. Our well-honed process and our experience allow us to quickly address physician concerns, establish credibility and trust, and speed the development process.

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“[Physicians] have decided they need to take action, and what they want to discuss is how. They recognize that improving quality and managing costs are part of their responsibility…”

Veralon Director John Harris

Veralon has been developing and advising PHOs since the early 1990s, and in the last few years, has done comparable work with CINs. We have handled engagements for over 80 such entities. We can support you by engaging physicians and hospital leaders in productive discussions, supporting creation of a vision and guiding principles for the CIN, and facilitating planning and development. Then we can help you in:

  • Making the critical decisions to address the right structure for each Clinically Integrated Network based on your situation; including tax status, approach to capitalization, member responsibilities, and the contracting process and authority
  • Designing governance structure and participation agreements, working with legal counsel, and providing guidance on key decisions
  • Creating business and implementation plans
  • Identifying payer contracting strategy, e.g., health system self-funded plan, other self-insured employers, risk contracts and/or bundled payments
  • Establishing an operating plan to achieve clinical integration
  • Defining an IT strategy to support the clinical integration plan
  • Developing and testing the financial impact of incentive funds distribution models
  • Modeling the financial impact of the CIN on utilization and on system and CIN revenues

Once development is completed, we can support initiatives in clinical integration implementation or CIN participation in an ACO, bundled payment program or other value-based payment model.