There are different options available for participants to share their data, including using additional software to connect each individual system or manually downloading and entering data. But since these options often require additional steps and cost time and resources, a suggested strategy is to survey all participants to identify most common EHRs used in the network and use that information to pinpoint the easiest and cheapest alternative.
Once a database is established, continuous data collection and analysis must occur to identify best practices and areas for cost reduction, so a significant amount resources and time are spent before any meaningful outcomes are realized. This means there is a long waiting time before physicians see any return on their investment, including cost savings or reimbursement bonuses. Because of this, it is critical to set clear and realistic expectations for physicians entering into an agreement to join a CIN.
Many CINs have also failed to allocate the necessary resources, such as effective use of EHRs, and personnel to measure return on investment from care management activities and resource utilization, leading to struggles negotiating with payers. CINs therefore must be willing to allocate necessary resources in order to demonstrate continual clinical improvement and effective management of total cost of care.
Participating physicians have a larger referral network for their patients, but many CINs fail at utilizing this network to improve referrals. Many physicians may be used to a specific practice in referring patients, and a particular CIN may not be putting enough emphasis on more effective referral within their CIN. A recent article published by advisory board stated that a specific 13-hospital CIN found that more than 40 percent of their employed physicians were referring patients to non-network providers. This not only led to loss of potential revenue for care provided, but also loss of valuable information for each patient sent out of network. It is critical for a CIN to make effective referral management a major goal as well as provide members with easily accessible information about physicians in the CIN.
Over the past few years, CINs have become an increasingly popular solution to challenges in the healthcare marketplace. CINs offer many benefits for participating members, including interconnectedness between healthcare providers; contributing to data-driven, evidence-based best practices; increased savings and reimbursement bonuses; and the potential for improved reimbursement from payers. These benefits also extend to patients under the physician’s care. Although CINs can potentially be a great model, there are many barriers to their implementation. They require a large time and resource commitment from members, clear goals and objectives set forth by their leadership, and an organized and efficient technology component for continued management and analysis of data. If these challenges are met, CINs can be a great solution to improve physician and patient wellness.