Why a clinically integrated network (CIN) may be right for your employees in 2021
How CINs "walk the talk"
December 8, 2020
Shawn West, MD | Chief Medical Officer
You have likely heard of a clinically integrated network, or more commonly known as a CIN, being a popular healthcare management strategy. For employers looking to exceed the healthcare status quo, many have turned to CINs as the solution.
A clinically integrated network (CIN) is an entity comprised of like-minded healthcare providers that have made a conscious decision to take the leap into value-based care. Value-based care means providers are paid based on the overall value rather than the volume of services rendered. This value-based payment structure realigns the incentives around the patient and the population the provider is managing. With this payment model, doctors are incentivized to optimize the quality and cost of the medical care and experience for the patient. Put your money where your mouth is, right? Well, here it is!
In addition to a payment model that aligns with employer priorities, CINs are different from the status quo in that they share a common information platform. This allows doctors from different specialties and locations to easily communicate and coordinate care which reduces duplication of services, organizes interactions with the member, and enables better management of care. One of the greatest and lesser-known aspects of working with a CIN like Embright is that this model brings doctors and employers together to customize health plan design, strategy, and tactics. Bringing together employers and doctors at this crucial time enhances the ability of the benefit plan to match the unique needs of the employee population and cost drivers. This direct communication channel creates space to set aligned priorities, mutually set improvement goals, and employ specific efforts that complement the existing health and wellness programs.
Another critical distinction of CINs is that decisions on how best to provide care are directed by actual medical professionals. And quality improvement processes are followed to ensure members get critical care screenings, and chronic conditions are managed to the goal. It's all about the member getting the right care at the right place by the right kind of provider.
For example, your employees and dependents tend to have low utilization of colon cancer screening and high utilization of the ER. We can develop and implement a customized set of physician-directed patient outreach, care management, and care pathways to engage members and address utilization trends.
All of these efforts are supported and coordinated by a team of experienced, diligent, and proactive care navigators who manage the legwork. Members then can focus on what matters most — their health — rather than the Byzantine processes. Additionally, dedicated care managers jump in and help those with the most complex situations to make sure the member gets what they need and stay engaged in improving their health.
When you add it all up, CINs hit the Triple Aim of higher quality care at a more affordable price and a better experience.