Rewarding Value

A new clinically integrated network aims to improve patient care via a value-based approach. 

By Pete Mercer

November 2023- The Journal of Healthcare Contracting

As more healthcare industry payment models shift from fee-for-service to a value-based approach that rewards clinical excellence, health systems have a unique opportunity to make changes within their own organizations to meet those changes head-on.

In anticipation of these changes, ChristianaCare recently launched a new clinically integrated network called the ChristianaCare Clinical Alliance. A press release announcing the launch described it as a “formal partnership among clinicians who work to deliver well-coordinated, evidence-based care to improve quality, efficiency and health outcomes.”

This network is intended to meet the challenges of today’s complex and fragmented healthcare delivery system. When physicians partner with the ChristianaCare Clinical Alliance, they are supported and resourced by ChristianaCare, a nationally ranked health system based in Delaware.

Christine Donohue-Henry, M.D., MBA, chief population health officer at ChristianaCare, said in a press release, “The launch of the ChristianaCare Clinical Alliance marks an exciting new phase in this journey, and we look forward to partnering with clinicians and health care organizations throughout Delaware to be increasingly more successful in helping people achieve optimal health.”

What is a clinically integrated network?

A clinically integrated network is an arrangement where hospitals and independent providers with similar goals and visions share performance improvement, quality, efficiency, and value goals that result in improved quality across the board and coordinated care at a lower cost. The clinically integrated network is more of a distinct and singular entity, or the specific organizing structure that providers join when they form an ACO.

These networks serve a critical function in the care continuum, working together to create better cost options for medical care. Members of these networks are provided with tools, analytic insights, efficiencies and economies of scale to help them deliver better outcomes for patients, while enabling smaller practices to participate in value-based payment arrangements with payors that might not be available otherwise.

Networks like this can provide a unique turning point for healthcare providers in a dynamic and constantly changing environment. As expectations for healthcare continue to change and technological advancements continue to emerge, providers need to be prepared to shift with the changing current. The ChristianaCare Clinical Alliance is an attempt to meet that shift head on.

“The health care industry is changing rapidly as payment models shift from fee-for-service to value-based models that reward excellent clinical outcomes – often referred to as population health. ChristianaCare has been preparing for these changes over decades. We have made investments in the infrastructure and expertise to be successful in this new environment,” Dr. Donohue-Henry said.

How it benefits members

According to the release, participants in the ChristianaCare Clinical Alliance will be able to access value-based care arrangements with payors that will provide financial rewards and incentives for improving quality of care and reducing utilization. Additionally, members will have access to tools like ChristianaCare’s CareVio, a robust information technology platform that harnesses real-time health data from all available sources.

CareVio offers members of the Clinical Alliance an IT system that captures and analyzes volumes of clinical and claims data to support clinical decision making and a support system that will help to address health equity issues amongst the patient base. There is also a team of healthcare professionals who are available to address clinical, behavioral, and social care needs that patients are experiencing.

Using collected patient data, members will also have access to a streamlined workflow, allowing them to optimize patient care and improve practice efficiency. The network will provide expert support for quality, reporting, and practice optimization.

That data allows physicians to provide higher-quality, efficient care from a network of physicians that are working together to follow consistent clinical programs and protocols. In addition to including primary care physicians, the ChristianaCare Clinical Alliance will include clinicians from the healthcare continuum.

How it benefits patients

In addition to the improved quality of patient care, there are many benefits to a clinically integrated network. Because data is such a significant pillar for this kind of organizational arrangement, clinically integrated networks can build comprehensive datasets for patients for better population health management. With the right infrastructure in place, these networks can collect, organize, analyze, and stratify data to share critical insights with other providers in the network, which could include gaps in patient care, coding opportunities, or alerts regarding transitions of care.

As the healthcare industry continues to rely on things like data and technology, networks like the ChristianaCare Clinical Alliance have the unique opportunity to improve and prioritize the value of patient care over the volume of patients they see. With a value-based care approach, physicians can encourage a network-wide, team approach to patient care that elevates the entire experience.

Tony Reed, vice president of population health operations at ChristianaCare said in a news release, “We have a rich track record of ensuring that our patients remain at the center of all that we do. By developing an innovative infrastructure within our clinically integrated network, we are able to deliver the best outcomes to each patient we serve. Our clinically integrated network touches nearly every component of the care continuum including primary care, specialty care, behavioral health, hospitals, post-acute care and community organizations which help address the social determinants of health.”

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