Issue link: https://beckershealthcare.uberflip.com/i/576097
128 Executive Briefing: data and baseline their current status to create a value proposi- tion for potential payers and employers. After considering their own agreements to which they're contractually bound, they create a roadmap of a more sophisticated set of data-driven quality measures. Naturally, the most fitting measures depend on the maturi- ty of the network and its makeup in terms of specialties. For ex- ample, early networks use process-based measures and good citizen measures. More established CINs are interactive and work with measures to decide if existing programs are working, how to fix them and potentially how to raise the bar. Regard- less of its size and maturity, a CIN should focus on a select set of measures; otherwise it becomes difficult to drive them in a focused manner. Step Five Recruit Physicians Part of the physician recruitment process involves strength- ening ties with physicians who are already on subcommittees within the network. These individuals, called physician champi- ons, assist in spreading the word about the network. Physician champions are well respected, can communicate to their peers and help bridge the gap between physicians and hospitals. Physician champions should create presentations to share with physician recruits about what their role would be in the CIN, how they will benefit and the long-term gains the CIN would bring to the community. They can present this material to physicians in a variety of ways, whether via town hall meet- ings or on a one-on-one basis. Naturally, networks should con- sider and be sensitive of the history of the marketplace before presenting material to physicians. CINs attract physician recruits through a variety of ways, including the name recognition and quality performance of in- volved organizations, compensation packages and the popula- tion the CIN serves. Because physicians are data-driven, they're attracted to evidence-based quality measures and actionable data. They're also attracted to ease of use — the clinical integra- tion should make matters easier for physicians to understand. Step Six Measure and Improve When the structure for the CIN is up and running, mea- surement and improvement efforts can be taken. Such efforts include how success is defined for the network and whether the network is committed to making improvements. For exam- ple, some networks are paid for fulfilling each quality standard, while other, more mature networks examine their overall im- provement on a quarterly or yearly basis as a way of measuring success. A CIN can perform self-assessments to discuss perfor- mance and pivot measures in case they're not working. The network can continually refine and examine its strategies to improve outcomes. "[Successful CINs are] constantly refining care delivery and coordination across the network and looking at new strategies and evidence-based approaches to improve the outcome of the population the network serves," says Donna Costanza, vice president of strategic solutions with Conifer Health. "When all the CIN's participants have the right data at the right time to adjust to better manage costs and or boost quality, then that is a sign of success." Step Seven Engage Payers The final step in the process is engaging payers in negoti- ations. Payers should only be integrated after legal standards have been agreed upon and the network has demonstrated it has a data-driven set of goals. The network's value proposition to payers is the ease of working with a single organization that will provide all the care and services to their customers while lowering cost and im- proving quality. Naturally, payers want to engage with networks that share its goals. In more practical terms, payers appreciate the adminis- trative ease that accompanies working with an organization that can do it all, from creating the infrastructure to providing the services. If a CIN can prove it can expand and attract more employers, payers will be interested. "It's about going to the payers and being able to articulate that you're helping them define a better place for their mem- bers to receive care," says Ms. North. Conclusion Through recruiting participants, developing governance framework and participation agreements and selecting quality measures, a CIN is on its way to success. Once established, the network can begin self-assessing its progress to ensure suc- cessful outcomes. An ideal CIN connects primary and specialty care physicians, acute care hospitals and outpatient care before approaching payers for support. The tie between these ser- vices results in a variety of benefits, including improved access to quality care, insights into the health of market populations and better management of patients across the continuum of care. n Sharing clinical information is the first step in transforming to value-based healthcare. Conifer Health can help you build a strong foundation for accountable care with proven processes and solutions other hospitals and physician groups have been using for more than two decades to establish and successfully manage their clinically integrated networks. Our Clinical Integration services and solutions help you formulate your strategy, design and implement your network, partner with physicians, measure performance and manage financial reimbursement—all backed by a Clinical Integration Intelligence Platform that turns your data into actionable insights. Conifer Health Solutions is a healthcare services company helping more than 800 clients strengthen their financial and clinical performance, transition to value-based care and enhance the consumer and patient healthcare experience, with the goal of improving quality and access to healthcare, while controlling costs. Conifer Health has more than 24 million patient interactions across all service lines, manages more than $26 billion in patient revenue and $18 billion in medically managed spend. Conifer Health also provides technology and health management services to support care management for more than 5 million lives, annually. For more information, visit conifer- health.com or follow @coniferhealth on Twitter. Sponsored by: 7 Steps to a Clinically Integrated Network