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Clinical Integration Enables Leading Health Systems to Deliver Higher Quality, Cost-Effective Care
Date:9/6/2011

WASHINGTON, Sept. 6, 2011 /PRNewswire/ -- In today's economic and health care environment, hospitals face increasing urgency to strengthen relationships with physicians.  Among the concerns are an aging population driving increased demand for health care (and a growing Medicare population), reimbursement reductions and changes, and physician shortages in key specialties. In this environment, it is more critical than ever that hospitals engage physicians to enhance health care quality while also improving efficiency and cutting costs across all care settings.

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To achieve these goals, physician organizations at leading systems such as Covenant Health System, a member of St. Joseph Health System based in Orange, CA, and Memorial Hermann Healthcare System of Houston have developed Clinical Integration (CI) programs.  These programs can serve as a bridge for hospitals to join the Medicare Shared Savings Program after first developing accountable care capabilities through contracts with private payers and local employers.

In Clinical Integration programs, a network of independent physicians collectively commits to collaborate with a hospital or health system to delivering improvements in quality and cost of care.  Once the CI program is established, physicians in the CI network may negotiate collectively for commercial payer contracts and present them for antitrust review by the Federal Trade Commission (FTC).  These contracts can include pay-for-performance components that allow both physicians and hospitals to receive incentive payments for improved quality and efficiency achieved via enhanced collaboration, which must be demonstrated through compliance with recognized clinical best practices and improved outcomes.  

Both Covenant and Memorial Hermann developed their CI programs with CRIMSON (R) physician performance technology services from The Advisor
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