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Deep Dive: Challenges, Successes and Outlook of Three Clinically Integrated Networks

Deep Dive: Challenges, Successes and Outlook of Three Clinically Integrated Networks

In this insight report from URAC, "Deep Dive: Challenges, Successes and Outlook of Three Clinically Integrated Networks," Phoenix Children’s Care Network, St. Vincent’s Health Partners, and Catalyst Health Network share how accreditation helped these systems save millions of dollars, exceed quality goals, create successful partnerships and improve payer reimbursements.

Structuring a clinically integrated network (CIN) is complicated — it can be fraught with clinical and operational hurdles, as well as financial, legal and regulatory obstacles. During interviews, these three CINs discussed the challenges they faced and the successes they’ve achieved, including:

  • More than $20 million in realized savings for one CIN’s attributed population — a direct result of a post-accreditation higher functioning network and other partnerships.
  • New reimbursements from payers that, in some cases, had been unwilling to pay anything prior to becoming URAC accredited.
  • Large savings on attorney and consultant fees by bringing the majority of legal counsel in-house.
  • Recouping a $1 million loss from the Bundled Payment Care Initiative program, and projecting a $1 million surplus, and opportunity to gainshare.
  • Approximately $3 million in savings generated for four employer groups over a one-year period.
  • Substantial reduction in the total cost spent on the most acute, high-risk patients among the CIN’s employer groups compared to other employer groups.