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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.

History of the clinical integration model

The clinical integration model in health care has been around since the industry undertook widespread efforts to control costs in the 1980s and 1990s. The Federal Trade Commission (FTC) first defined clinical integration in 1996, and some physician organizations have considered themselves clinically integrated for decades.

However, today’s clinical integration model is different than that of earlier efforts. In the past, clinical integration focused on creating physician-hospital organizations (PHOs), integrated delivery networks (IDNs) and other practice acquisitions and consolidations. The goal was to create a clinical integration model that gave hospitals and health systems greater control over admissions and cost, and improve negotiations and contracting with payers.

But the integrated entities of decades past did not become skilled at managing physician practices. These groups rarely had the infrastructure to manage the risk assumed under contracts with managed care organizations, and there is little evidence that they actually improved value—that is, provided good patient care while containing costs. These groups were really superficially linked provider networks rather than truly integrated systems. After significant financial losses, this kind of clinical integration model was abandoned.

There are several factors that make current clinical integration models different and more promising:

  • Today’s strategies do not require the acquisition and purchase of practices. In fact, independent physicians that align with networks of providers play a significant role in clinically integrated care.
  • While earlier physician-hospital groups were set up as open networks, today’s clinical integration demands that providers maintain a more uniform, high standard of care.
  • Advances in health information technology (HIT) make information-sharing easier and more affordable. HIT has evolved to meet new standards of secure, interoperable and comprehensive exchanges of information and health care leaders can now look to several kinds of HIT solutions—such as electronic medical records (EMRs), health information exchanges (HIEs) and data aggregation solutions—to support the clinical integration model.

The potential for financial gain is there, too: Because clinical integration gets physicians working in a more united way to ensure the delivery of optimal, efficient care, clinical integration is a strong foundation for moving toward new payment models that reward providers for high-quality, high-value care.

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