Evaluating a Super CIN Opportunity

Evaluating a Super CIN Opportunity

Is participation in a super clinically integrated network (CIN) in your organization’s future? Here are some questions for health care organization boards and leadership to consider.

Organizational Alignment

  • Is there a shared commitment from all parties to collaborate for improved outcomes, quality and value?
  • Are physicians willing to support the concept?
  • Has the value to the marketplace and patients been vetted and documented?

Governance

  • Does the ownership/governance structure recognize each participant’s contributions and not just their relative size?
  • Does the ownership/governance structure clearly spell out the decision-making processes on critical issues?
  • How are physicians represented in the governance structure?

Financial Metrics

  • Has the cost avoidance proposition been quantified?
  • Has the long-term value of additional covered lives been quantified, including the difference in “going it alone?”

Operating Model 

  • How/where will care management functions be centralized?
  • What are the expectations to standardize care delivery processes and outcomes?
  • How much local flexibility will the hospital and its physicians have in implementation?

Legal/Regulatory 

  • Has the plan been reviewed by outside counsel specifically versed in CIN/super CIN development?
  • Will FTC review/opinion be required? Now? Or at some point in the future?

Source: Karen Hohenstein (khohenstein@navigant.com), Managing Director, Navigant Consulting’s Healthcare Practice, Chicago. (For more on super CINs see her Center Voices article “Independent and Integrated” in the October 2014 issue of Trustee magazine.)