What is a clinically integrated network?
The Federal Trade Commission defines clinical integration as “an active and ongoing program to evaluate and modify practice patterns by the network’s physician participants and create a high degree of interdependence and cooperation among the physicians to control costs and ensure quality.” A Clinically Integrated Network (CIN) is a flexible and collaborative organization of providers, developed and driven by physicians, dedicated to creating value in healthcare. In this model, physicians work together to coordinate care, implement best practices and set standards of care to measure performance as a team of high-quality, cost-efficient providers.
What are the costs to participate in Health Leaders Network (HLN)?
There will be no up-front costs to join the network. Members are expected to dedicate their time and efforts to clinical and quality improvement initiatives, and must be willing to share clinical data.
How will HLN improve my patients’ ability to access specialists?
The network will be able to improve care transitions and enhance access for patients by developing evidence-based medicine protocols, data and referral processes and access standards across the continuum of care. These improvements will enable primary care physicians to manage the care of their patients more effectively and allow specialists to focus their efforts on those patients who need specialized care.
Do I need to have an electronic health record (EHR) to participate in HLN?
You do not have to have an EHR to participate at this time. However, participating providers must work within an EHR in their practice by 2017 that has met or will meet Level 1 meaningful use standards. Providers who currently do not have an EHR are still required to provide specific clinical data as determined by Health Leaders Network's Board of Directors.
How have physicians been involved in the development and leadership of HLN?
Health Leaders Network is founded on the idea of proactive physician leadership. A diverse team of physicians were engaged over several months to actively contribute to the design and development of the Network through four committees. Although the Network is legally a subsidiary of FMOLHS, it is governed by a 19-member Board, 15 of whom are practicing physicians. Network operations are directed by four committees that are led by physicians and include significant physician representation. These committees drive key elements of the clinical integration program, including quality and utilization metrics, clinical initiatives, incentive programs and data integration.
If we are sharing data, how will you protect my practice’s financial and patient information from competitors or from being used by researchers without my permission?
Our IT and Data Governance Committee has addressed this question by developing formal data governance policies. We will establish an oversight team to make sure the information is secure and managed appropriately to protect patients and providers.
How does contracting work under the HLN model?
HLN contracts will be negotiated by HLN staff and leadership and overseen by the physician-led Contracting and Finance Committee and Board. HLN contracts are separate from participating physicians’ existing fee-for-service base contracts. These contracts will be quality and performance-based “overlays,” designed around specific metrics to improve outcomes for a designated patient population. Your practice will still enter into and maintain its base fee-for-service contracts individually.
What type of clinical initiatives and programs will HLN offer?
The Quality and Care Coordination Committee of Health Leaders Network is in the process of defining and developing clinical initiatives. The first two priority programs have been developed around (1) Evidence-based Standards of Care for Heart Failure and (2) Transitions of Care. Efforts are underway to design additional clinical programs for the upcoming year.