How to Position Clinically Integrated Networks for Value-Based Care

Episode Overview:

Clinically integrated networks (CINs) help organizations align with providers. They position health systems, hospitals, employed physicians, and independent physicians to succeed under value-based care as the healthcare industry moves into more contracting opportunities. CINs also provide a vehicle to manage costs and create efficiencies, while allowing the network to track quality. In this episode of Value-Based Care Insights, Daniel J. Marino and Shaillee Juneja speak with Dr. Troy Tyner and Aaron Valerio to discuss how a large Midwest CIN created capabilities to support their employed and independent providers.

Episode Discussion Areas:

1. 2021 healthcare trends that affect the Midwest CIN

1. 1. Telehealth/virtual care
      - What did implementation look like in 2020?
      - What are potential challenges/opportunities to be addressed?
   2. Real-time delivery models
      - What are the major forces affecting the delivery of healthcare today?
      - Where are opportunities for improvement?
   3. Contracting
      - How has value-based care played a role in commercial contracting?
      - What are the future predictions?
   4. New Administration
      - What will occur as a new administration emerges?
      - What changes need to be on the radar?

2. CIN programs and practices

1. 1. What is the CIN doing to stay ahead of the curve in 2021?

3. Top-line growth versus operational activities

1. 1. What value-add operational activities can leaders provide?

9 Key Takeaways: How to Position Clinically Integrated Networks for Value-Based Care

1. CINs let organizations align with providers.
   1. CINs position health systems, hospitals, employed physicians, and independent providers for success under value-based care. CINs also provide a vehicle to help manage costs, create efficiencies, and track quality. A CIN allows independent physicians growth and success as they navigate 2021’s challenges.
2. Ways to help provider networks succeed.
   1. Telemedicine technology can help provider networks transition into virtual care. Network success is also affected by supporting organizations through value-based contracting.
   2. One of the most successful approaches is to financially support independent practices and help them create a robust business structure.
3. Engaging independent providers for quality collaboration
   1. Providers must feel that CINs will bring them success.
   2. Success can be achieved through basic messenger model contracts, educational programs, and purchasing programs to decrease the cost of doing business.
   3. Markers indicating value include saving money, reducing their cost structure, and moving the culture toward quality.
4. Engaging physicians with a pay-for-performance structure
   1. Use a phased-in approach to show providers value, but keep a pace that’s reasonable.
   2. Look at the whole ecosystem, ensuring practices are healthy, and then build trust.
   3. If you can build your infrastructure to support independent practices, you can address shifts in culture from fee-for-service to collaboration.
5. Trust is a key piece of the future of healthcare.
   1. It takes a level of trust with independent practices concerning revenue streams, participation, and negotiation. Providers cannot afford mistakes, so their risk tolerance is low. Navigating challenges together can instill confidence.
6. Strong physician leadership is critical for progress.
   1. Most physicians do not systematically receive business and leadership training.
   2. Hosting educational seminars and lunch and learns, addressing specific issues on podcasts, and providing training on different skillsets can forge relationships with physicians, hospital administrators and CFOs.
7. Find opportunities to align conversations.
   1. Help physician leaders with business acumen and leadership training, as well as the nuances of “administrative speak.” It’s just as important to be able to translate “administrative speak” back to doctors and colleagues.
   2. Being able to align these conversations, make the translations, and set expectations among the different parties is an important and unique skill set.
8. COVID created opportunities for offering provider support
   1. COVID has expedited the push toward change. Performance will be critical - it’s important to develop processes that lead to better outcomes — whether that’s success through contracts, managing costs, or other strategies.
9. Create smart solutions that ensure success.
   1. Readily available solutions — like webinars about telehealth, coding, and compliance — can help contain costs and manage the changes that will arise throughout the year.
   2. This year, it will also be more important than ever to rebound from poor performance which requires engaging physician leaders and collaborating with them.

About Value-Based Care Insights Podcast

Value-Based Care Insights is a podcast that explores how to optimize the performance of programs to meet the demands of an increasing value-based care payment environment. Hosted by Daniel J. Marino and Shaillee Juneja, the VBCI podcast highlights recognized experts in the field and within Lumina Health Partners.