Improving Value and Care Metrics Through a Clinically Integrated Network

Navigant's Katherine Ziegler and Donna Cameron Featured in HealthLeaders

Healthcare has always searched for the holy grail—the disruptive force, construct, or innovation that will make vast and necessary improvements in quality while simultaneously slowing healthcare's rapid cost growth. Yet such a solution has eluded everyone from policymakers to patient advocates to senior healthcare executives.

Many organizations see big data's possibilities and are betting that the right tools and strategies coupled with an organizational structure that gathers data from disparate parts of the healthcare service universe—otherwise known as clinically integrated networks (CINs)—will yield big gains in both efficiency and quality.

There are four areas of focus that have the most significant impact on successful CIN development: physician engagement, in-network care coordination, postacute care utilization, and management of pharmacy spending. Overall, organizations can achieve great success if there's agreement around clinical standards and effective incentives or disincentives for following them.

Katherine Ziegler, Navigant Managing Director, HealthLeaders

CINs are designed to improve that metric in part by applying standards of care based on a patient's disease state for which clinicians are held accountable. Healthcare organizations are eagerly embracing CINs as a structure that allows efficiency to flourish without the huge cash outlays necessary to acquire healthcare business assets. Organizations that can manage efficiency well should be well positioned for slowing growth in the long term.

Organizations learning from others that have been successful with a CIN strategy are taking time to conduct capabilities assessments. Creating analytics functions with existing organizational data is important because doing so helps organizations get a head start on targeting where to provide resources.

Donna Cameron, Navigant Managing Director, HealthLeaders

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