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Clinical integration knowledge hub

Learn about the importance of implementing a successful clinical integration strategy, along with some obstacles to avoid along the way.

Aligning incentives across the care continuum

To implement a successful clinical integration strategy across the care continuum, hospitals and health care systems need solutions that align and engage providers across the health care delivery spectrum: clinically, technically, culturally and financially.

For clinical integration efforts to work, the strategy must be in every participant’s best interest. That’s why the key to deeper and long-lasting clinical integration across the care continuum may be the maintenance of strong relationships with stakeholders through financial incentives or formalized contracts. When incentives are aligned, physicians’ actions can be as well.

For employed and affiliated physicians, that might mean being rewarded for accessing jointly negotiated payer contracts, for referring to in-network or other quality-focused providers, and for acquiring more referrals by focusing on cost and quality. The reason for financial reward is because entities such as labs and radiology centers benefit from more efficient ordering and operations, less work for their staff and the ability to process more orders.

To align incentives for better care management, health care groups need to develop a common, measureable picture of success that delineates clear, tangible (ideally financial) benefits to all stakeholders working together in the clinical care continuum. Participants in this effort should include hospitals and their employed and affiliated physicians, ambulatory surgical centers (ASCs), independent medical groups, and labs, pharmacies, patients and payers.

Today’s financial alignment programs are increasingly emphasizing quality metrics rather than visit volume and productivity. Health care organizations are moving away from compensation that rewards only productivity or RVUs (relative value units), since this approach has not been effective in improving the quality of care management or fostering clinical integration.

Instead, some experts recommend using salaries and bonuses with a more holistic approach to “reflect the values of clinical integration, including collaboration in teams, effective and timely use of ancillary personnel, deployment of communication systems, and techniques that permit patients to manage their care effectively, patient experience of care, and adherence to the evidence-base.”1

Finally, any financial ties between provider organizations must comply with state and federal laws and regulations.

1 Gosfield, A.G. and Reinertsen, J.L. Achieving Clinical Integration with Highly Engaged Physicians. (2010.) Available at:

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