FAQ

A: A Clinically Integrated Network (CIN) brings together physicians and other medical facilities that collaborate to improve quality and efficiency of care. The structure of these networks encourages a team-based approach to care delivery and allows for greater sharing of patient data and best practices. CINs are able to leverage the unique strengths of independent physician practices and share resources — such as technology, care management programs and infrastructure investments.

A: Clinical integration fosters interdependence among physicians who, by working together on the quality initiatives they select, are able to achieve higher quality and greater cost-effectiveness than they likely could accomplish on their own.

A: In most instances, clinical integration involves independent physicians and a regional health system joining together to create a structure and management capabilities to:

• Identify and adopt clinical protocols for the treatment of particular disease states
• Develop systems to monitor compliance with the adopted protocols on both an inpatient and outpatient basis
• Contract with health plans and local employer self-insured plans in a way that financially recognizes the physicians’ efforts to improve health care quality and efficiency

A: The goal of the SJHP network is to provide enhanced patient experiences and improved health of the community through a coordinated continuum of care that is focused on quality, performance, efficiency and value.

For physicians, the network offers the opportunity to:

• Join a preferred network of physicians and gain access to its contract members – including St. Joseph’s Health employees.
• Receive financial rewards for value-based outcomes and achievements
• Use of care management resources – exclusive to participating SJHP physicians.

A: Participating physicians or groups must:

• Comply with quality, safety and efficiency improvement programs
• Abide by established Clinical Integration policies and procedures

A: Yes, The Federal Trade Commission (FTC) requires Clinically Integrated Networks to be clinically and financially integrated.   As such, the SJHP will negotiate on behalf of all its participating physicians under one contract – often referred to as “single-signature” contracting.

A: The SJHP participation agreement requires physicians to participate in each clinically integrated payer contract negotiated by the network.

A: The participation agreement stipulates that all members in a group must participate.

A: Participation in the SJHP network does not mandate any change in referral patterns – SJHP is not an HMO or an IPA.

A: The SJHP network is designed to support physicians and their staffs – by reducing office complexity, reporting and paperwork.

A: SJHP is physician led. Its Board of Trustees is composed of # ___ independent physicians, # ___ employed physicians and two representatives of St. Joseph’s Health. This governance structure ensures that actions will only move forward if supported by the physician trustees representing the network. The high percentage of physicians on the Board also ensures that clinical and practice insights are central to all decisions.

A: Federal Trade Commission (FTC) regulations require a clinically integrated network (such as SJHP) to measure and report on the quality of the care provided within the network. These measures have been designed to overlap with PQRS; however, they are not a replacement.

A: To join the SJHP network – contact:

• Name ____________________
• Phone: ___________________
• Email: ____________________