At Alaska Health Alliance with Providence, we’re here to answer your questions and serve as a resource in the pursuit of value-based care. Contact us to learn more.
Clinical integration is an effort among physicians and other health care providers, often in collaboration with a hospital or health system, to develop active and ongoing clinical initiatives that are designed to control costs and improve the quality of health care services. Participation in an effective clinical integration program gives a health care provider community the ability to contract collectively with preferred provider organizations and other fee-for-service health plans.
Clinical integration involves the “Three C’s” – care, connectivity and contracting.
Care: providers commit to uphold standards of quality that are recognized by the providers themselves as best practices consistent with scientific evidence and “the right thing to do.”
Connectivity: providers use technology to communicate with one another regarding individual patient care and the performance of the group as a whole to ensure high standards are upheld and that care is delivered in the most efficient manner possible across the continuum.
Contracting: providers gain the ability to participate jointly in contracting with payers and employers based on quality performance and outcomes of the entire group.
Doctors and other clinicians throughout the U.S. are joining together in clinically integrated networks to: (1) enhance the quality of patient care, (2) negotiate with payers as a network, (3) allow networks of health care practitioners and facilities to market themselves on the basis of quality and cost effectiveness, and (4) prepare for anticipated changes in health care reimbursement that result from federal health care reform.
Simply put, everyone benefits from a value-based approach to health care delivery.
Alaska Health Alliance with Providence develops more collaborative relationships with our medical staff, enlists physician support for quality initiatives and positions ourselves at an advantage in the market based on quality.
Through their participation in the network, providersdemonstrate their commitment to quality and efficiency to current and future patients, payers and employers and enter physician-directed collaborative negotiations for professional fees, pay-for-performance and other contractual arrangements with health plans and employers in a way that financially recognizes their efforts.
Patients and communities benefit from clinical integration because it enables network participants to tackle the complexities associated with delivering affordable, high-quality care and provide an improved patient experience through increased communication and shared metrics for success.
Our clinically integrated network is a stand-alone limited liability company, led and governed by a board of managers predominately composed of Anchorage-area physicians. To view the members of our board, click here.
The Alaska Health Alliance with Providence board operates for the explicit purpose of developing and implementing a clinical integration program, on the basis of which we negotiate contracts with health plans on behalf of participating physicians and other health care providers.
Because membership in the clinically integrated network is completely voluntary, all clinicians must choose whether they will participate in the network by signing a participation agreement.
Participants in the network are required to collaborate with their colleagues and Providence Alaska Medical Center in the development and adoption of a clinical integration program – a collection of clinical initiatives that will enhance the quality, service and cost-effectiveness of patient care.
All participating physicians and other health care providers must hold themselves and each other accountable for the quality performance initiatives of the clinical integration program, including its remediation efforts should clinicians not meet the benchmarks set by the network. The performance evaluation and remediation policies will be adopted by the physician-led steering committee, and performance improvement and remediation activities will be carried out by physician members of the quality committee under the network’s board of managers.
Participation in the quality and care management initiatives of the network’s clinical integration program will require time and attention from clinician practices and their office staff to ensure compliance with data reporting and other documentation elements integral to the program. In return, participating physicians and health care providers will be eligible to obtain financial rewards for their achievements through the clinical integration program, funded by contracted health plans.