What is a clinically integrated network?

It is a physician-led, formalized business entity between physicians and healthcare systems that creates interdependence by developing and implementing evidence-based, data-driven clinical initiatives to improve outcomes, increase efficiency and reduce costs in the inpatient and outpatient setting. By creating such interdependence through sharing data and bringing together a broad cross-section of the community, the CIN jointly negotiates managed care contracts to align payments and incentives with the performance and quality of the care delivered.

What is the overall goal of a clinical integration program?

The overall goal for entering into a CI program is to enhance the value of the services that are provided to a patient. In turn, by providing valuable services to patients, the CI organization positions itself as a valuable partner to the payor organizations, the referral network and the surrounding community.

Why is Lutheran Health Network creating a CIN?

The CIN is being established to improve care collaboration between independent physicians, employed physicians and Lutheran Health Network hospitals. The goal is to provide a platform for all three areas to provide input and establish standardized clinical guidelines, office best practices and a technology solution to improve access, quality and value for the patients and families in our region.

Why would a physician want to engage in a CIN?

  • Enhanced quality of care provided to patients
  • Support to remain in private practice
  • Improved alignment of services and care transitions across the care continuum
  • Access to IT solutions, quality data, outcomes research and other services
  • Negotiation vehicle with payors by demonstrating value through CI
  • Ability for network to promote itself on the basis of quality
  • Platform to help enable the network to develop integrated clinical protocols and best practices

Why is the CIN important to patients and their families?

The CIN’s mission is to enhance the health and well-being of our patients across the continuum of care - including primary care, inpatient and specialty services. This mission includes establishing best practice clinical standards and patient care protocols for all participating CIN physicians and their patients. The patient is at the center of the CIN and the coordination of care between primary care, specialty care and the hospital to avoid redundancies and gaps is a cornerstone of population health management.

What are the risks for providers to join the LHQA?

The risks of joining the CIN are minimal, since the network is focused on adding contracts that focus on quality incentives, without downside risk for performance. That said, failure to meet expectations around quality and efficiency might result in potential lost incentives and termination from the network.

Who is leading the CIN?

CIN operations is a physician-driven and physician-led organization. The board is made up of 16 physicians and two LHN administrators, along with an executive director, medical director and three committees made up of physicians and administrators, both hospital and independent.

How will providers be measured?

All network physicians (primary care and specialists) will be measured on quality and performance metrics. These measures were defined by the Quality & Technology work group during the design phase. The measures list will start small in years one and two and evolve as the CIN matures.

Do providers need to have an electronic health record (EHR) to participate in the CIN?

You do not have to have an EHR to participate at this time. We have selected a population health management tool that service practices on a variety of platforms. This data will be used to generate reports, identify gaps in care and ultimately improve population health management.

What will you do with our data?

This data will be used to generate quality reports, identify gaps in care and ultimately improve population health management.

What are the membership requirements and costs to participate in the CIN?

There will be no up-front costs for physicians to join the network. Members will be expected to participate in clinical and quality improvement initiatives and share clinical data. The CIN Steering Committee and Work Groups have designed the network to make the time and energy our participants contribute as efficient, productive and meaningful as possible.

How can I join?

For more information please contact CIN Project Director, Nicole Krouse at (260) 479-3558, nkrouse@lhn.net