Ongoing healthcare reimbursement reform and clinical performance transparency are designed to drive medical provider services towards the goals of the Institute for Healthcare Improvement’s Triple Aim: enhancing the quality and experience of care, reducing per capita healthcare costs and improving the wellness of our communities.
Clinically Integrated Networks (CINs) are highly structured collaborations between health systems and clinical providers designed to coordinate the resources needed to achieve Triple Aim goals and create a legal “safe harbor” for groups to affiliate in innovative ways for greater efficiency and community benefit. By thoughtfully designing processes that manage medical care throughout the spectrum of services and utilizing the most efficient, evidenced-based practices, these clinical networks are intended to achieve the best quality of care at the lowest cost – Value.
Despite earnest efforts by many healthcare systems to develop these networks, most have failed to deliver Value to either the marketplace or the patients that they intend to serve. In most cases, the reason is not poor design, but rather a failure to continue in network maturation and development. Figure 1 demonstrates the “Stages of Clinical Network Development” that currently exist across a number of healthcare markets.