Clinical Integration

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Clinically Integrated (CI) Networks

Hospitals, physicians and other medical providers working together to improve the quality of health care are often referred to as "Clinically Integrated (CI) Networks.” This team-based approach helps health providers communicate and collaborate on patient care.  Arizona Care Network (ACN) is a CI Network. 

ACN securely shares patient information among its provider participants as allowed under the law as an organized health care arrangement. 
 
ACN also participates in other organized health care arrangements.  Those other arrangements may include hospitals, health care providers, and health plans that share information to improve the quality of care and reduce costs. 
 
The ability to share information within an organized health care arrangement promotes coordination of care and is the cornerstone of improving patients' health care experiences, outcomes, and access to health care.   A detailed listing of the participants in each organized health care arrangement is available from the Privacy Official.

Through innovative care coordination programs, exceptional care continues after the patient leaves the doctor’s office. Care teams are essential to helping both physician and patient navigate the most complex of health challenges. Teams of health professionals work closely with patients to assist with doctor’s orders, medications and communication with their physician’s office. Arizona Care Network securely shares patient information among its provider participants as allowed under the law as an "organized health care arrangement.” This coordination of care and information is the cornerstone of improving patients’ health care experiences, outcomes and access to health care.

Arizona Care Network serves Arizona with confidence, compassion and quality while improving health outcomes to better treat complex conditions. We monitor quality and costs for accountable healthcare and are committed to bringing exceptional healthcare service and satisfaction to all of our members.

Defining Clinical Integration and Accountable Care

Clinical Integration

Clinical integration is a physician-led program that will improve quality and efficiency, and allow for new avenues for reimbursement from commercial fee-for-service payers. This program will be a physician-driven, physician-led, and physician-managed effort to develop and maintain active and ongoing clinical initiatives designed to control costs and improve the quality of inpatient and outpatient care. The CI Network of Physicians will work collaboratively, share data, and hold each other accountable for performance against physician developed and agreed upon clinical performance and efficiency standards.

 

Accountable Care Organization (ACO)

An ACO is a group of providers and suppliers of services (e.g. hospitals, physicians, and others involved in patient care) that will work together to coordinate care for the Medicare fee-for-service patients they serve. The goal of an ACO is to deliver seamless, high-quality care for Medicare Fee-for-Service beneficiaries, instead of the fragmented care that often results from a fee-for-service payment system in which different providers receive different, disconnected payments. When specific goals and benchmarks are met, an ACO has the opportunity to share in the cost savings created by improved care coordination. Arizona Care Network was approved to participate in the Medicare Shared Savings Program beginning January 1, 2013.

 

CI and ACO Coordination

The principles and goals of CI and ACO correlate nicely in an effort to improve quality of care and patient health while lowering costs. CI is a broad strategy that will incorporate over 100 quality measures across all specialties and inpatient/outpatient settings to then negotiate directly with commercial payers. The CI Network of Physicians provides an ideal quality platform for developing an ACO that will participate in the Medicare Shared Savings Program and focus on the 33 required quality initiatives. Physicians have the benefit of participating in both the clinically integrated and accountable care components of Arizona Care Network.

 

 

A Physician and Health System Collaboration