Building a Clinically-Integrated Network

Case Study: Monument Health

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Challenge

As value-based payment models evolve, providers are challenged to maintain superior clinical outcomes while controlling costs.  Aligning health professionals around standard care protocols, payment incentives, technology infrastructure, and performance monitoring is complex, but it is possible with a clinically-integrated network (CIN).

In 2014, St. Mary’s Hospital and Regional Medical Center, a facility that serves Grand Junction, western Colorado and eastern Utah, partnered with Navigant to evaluate the viability of a CIN with Primary Care Partners of Mesa County, Colorado. The independent primary care physicians group and other physician affiliates wanted to create a more collaborative, low-cost approach to population health and to adapt to changing market conditions.

Solution

During the assessment stage, Rocky Mountain Health Plans, an independent, not-for-profit health insurance carrier headquartered in Grand Junction, joined the cooperative adding payer expertise to the enterprise. The organizations established a set of 10 guiding principles that their partnership must accomplish, including achieving continuous improvement toward the Triple Aim, benefiting all parties and the community, and creating shared governance while maintaining physician autonomy.

Results

St. Mary’s Hospital and Regional Medical Center, Primary Care Partners and Rocky Mountain Health Plans:



Monument Health Case Study

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