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    Understanding clinically integrated networks

    With physicians facing pressure from all sides to deliver better quality care at a lower cost, clinically integrated networks (CINs)  offer new approaches with some unique features compared with other types of physicians’ groups.
    Run by physicians, sometimes with sponsorship by a hospital, CINs are networks of providers who use shared electronic health record (EHR) systems to track which methods of clinical care deliver the best bang for the healthcare buck among the patient population—and share that information so all can benefit.
    There are about 500 CINs in the U.S., according to a 2015 white paper by Caradigm, a healthcare analytics company based in Bellevue, Washington. Their numbers have grown since 1996, when the Federal Trade Commission provided guidance on its anti-trust policies regarding healthcare organizations, so affiliated healthcare organizations could avoid anti-trust violations.
    When it comes to CINs, “the keywords are efficiency, and low-cost but high-quality care,” says Glenn P. Prives, JD, an attorney at McElroy, Deutsch, Mulvaney & Carpenter, LLP in Morristown, New Jersey who has worked with CINs.
    The vast majority of CINs are negotiating alternative, value-based contracts with payers, says Tomas Mikuckis, a Boston, Massachusetts-based principal in the health sciences group of Oliver Wyman, an international management consultancy based in New York City.


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