In “real life,” what does a clinically integratied network look like?

In many instances, a clinically integrated network is made up of one or more hospitals or hospital systems and a select group of the employed and independent physicians on the hospitals’ or health systems’ medical staffs. Typically, these parties work collaboratively to:

• Coordinate care across providers and sites-of care;
• Plan and implement initiatives that will promote evidence-based medicine and patient-centered healthcare;
• Address quality, cost, and/or utilization of healthcare services in and across the inpatient, outpatient, and physician practice settings;
• Enable participating providers to deliver and demonstrate optimal quality performance and clinical outcomes;
• Position all parties for financial sustainability; and
• Enter into physician-directed “pay-for-performance” and other contractual arrangements with health plans in a way that financially recognizes the physicians’ efforts to improve health care quality and efficiency, as long as they remain in compliance with FTC and DOJ guidance and precedent.

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