Clinical Integration

A new era of demands on clinical businesses requires simplifying care delivery for your “customers.” Regardless of the type of provider (e.g. hospitals, physicians, ACOs, diagnostics), the market expects a collaborative approach to care delivery.

Payers and patients also demand single-source, high-quality, low-cost care that is difficult to provide without an integrated model. Clinical integration allows providers to interface with their customers (payers and patients) to meet these needs.

While frequently misunderstood, clinical integration is a pre-requisite to high performance in the post-reform era. The phrase “clinical integration” is sometimes used as a legal threshold for joint contracting, a stand-alone strategy, a specific tactic, and even a cultural goal. Regardless of what clinical integration means to your organization, it is an important milestone on the path to responding to the pricing, contracting, transparency, and consumerism pressures of the post-reform market.

Clinical integration maintains three principal goals:

  1. Securing physician alignment
  2. Demonstrating high-quality, low-cost evidenced- based practice
  3. Managing population health

To achieve these goals, PYA offers the following clinical integration services:

Physician-Hospital Alignment – Securing physician performance and buy-in

  • Clinical co-management and professional service agreement design and development
  • Employed-physician enterprise evaluation and integration
  • Return-on-investment calculations for alignment initiatives

Performance Metric Design – Incentivizing strong performance on quality and cost

  • Value-based physician compensation and transaction structures
  • Quality metric selection for inclusion in physician and transaction contracts
  • Publicly reported quality metric response strategies

Physician Executive Services – Offering executive-level physician perspective

  • Temporary chief medical officer services
  • Employed-physician enterprise, medical staff, or affiliated group retreat facilitation
  • Physician personnel services

New Care Model Development – Putting clinical integration to work

  • Accountable Care Organization development including expertise in the Medicare Shared Savings Program
  • Clinically integrated network design, development, and operations
  • New payment and care delivery models

Each organization is in a different place along the path to clinical integration. Find out where you are and where you want to go. Let’s talk about “turning theory into practice.”

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